Abstract

MEZZANO, Emilio et al. Tratamiento quirúrgico de aneurismas intracraneanos no rotos. Rev. argent. neurocir. [online]. 2009, vol.23, n.1, pp.23-28. ISSN 1850-1532.

Objective: To present and analyze our experience in the surgical treatment of patients with a diagnosis of unruptured aneurysms. Materials and Method: 37 patients with a total of 43 unruptured aneurysms, who were surgically treated between January 2004 and May 2008. These patients were classified in 3 groups according to their diagnosis: incidental (14 patients), symptomatic (11 patients) and those who had previous subarachnoid hemorrhage (SAH) caused by the rupture of another aneurysm (12 patients). Results: All the patients were surgically treated with craniotomy and aneurysm clipping. In carotid-cavernosus cases (5 patients), carotid trapping was chosen only if the patient tolerated the oclussion test, if not, an extra-intracranial high flow bypass was chosen. Out of 37 patients, 4 presented after-effects and 3 patients died immediately after surgery: 1 because of spontaneous intraparenchymatous hemorrhage, 1 because of complications related to SAH (Hunt- Hess V) and 1 due to surgery-related complications. With a maximum of 53 months of post-operative follow-up, no cases of recanalization or rupture of any treated aneurysm were found. The surgery-related mortality was 2.7 % and the morbidity was 5.4%. Conclusions: In the presented series no relation between the aneurysm size and the post-operative prognosis was found. We agreed with the morbidity and mortality published on the big series, and that the posterior circulation aneurysms had the highest morbidity. We believe that unrupted aneurysms should be treated, being surgery the chosen treatment because of its verified efficacy in short and long term.

Keywords : Unruptured aneurysms; Incidental aneurysms; Surgical treatment.

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