An Analysis of the Result of Surgical Treatment of Anterior Communicating Aneurysms.

Song, Jin Un; Lee, Young Kun; Choi, Chang Rak; Kang, Joon Ke; Song, Jang Sung; Ha, Yung Soo; Lee, Choon Jang; Kim, Dal Soo; Sung, Tae Kyung; Ahn, Myung So; Huh, Choon Woong; Ju, Mun Bae; Kim, Yung Jin

Original Article

Journal of Korean Neurosurgical Society 1974;3(2): 167-176.

Jin Un Song, Young Kun Lee, Chang Rak Choi, Joon Ke Kang, Jang Sung Song, Yung Soo Ha, Choon Jang Lee, Dal Soo Kim, Tae Kyung Sung, Myung So Ahn, Choon Woong Huh, Mun Bae Ju, Yung Jin Kim

¹Department of Neurosurgery, Catholic Medical College, Seoul, Korea.
²Department of Neurosurgery, Korea General Hospital, Seoul, Korea.

ABSTRACT

The authors attempted to analyse the factors influencing the mortality involved in aneurysm surgery based on 38 cases of intracranial surgery for anterior communicating aneurysms, and obtained the following conclusion. 1. The surgical results are much better when the aneurysm surgery is delayed over one week after the occurrence of aneurysmal rupture, if there is no evidence of intracerebral hematoma. Administration of a massive dosage of epsilon aminocaproic acid in the waiting period prior to aneurysm surgery seems to be effective for preventing recurrence of bleeding from the aneurysm. 2. The direction of the anterior communicating aneurysm should be clearly visualized on a cerebral angiogram so that the most effective aneurysmal approach can be selected in surgery. 3. Microsurgery and hypotension in aneurysm surgery minimize brain damage in the exposure of aneurysm and provide accurate isolation of the aneurismal neck from the parent vessel in aneurysmal neck ligation. 4. Proximal ligation of the anterior cerebral artery is also an effective procedure to prevent recurrent hemorrhage from anterior communicating aneurysm.