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No Shinkei Geka

Title:		"[Direct surgical management of giant and large intracerebral aneurysms, associated with intraluminal thrombus and/or atherosclerotic thickening of aneurysmal neck]"
Author(s):		Uede T; Ohtaki M; Tanabe S; Hashi K;
Address:		"Department of Neurosurgery, Sapporo Medical University School of Medicine"
Journal Title:		No Shinkei Geka
Year:		1997
Volume:		25
Issue:		11
Page Number:		1007 - 1015
DOI:
ISSN/ISBN:		0301-2603 (Print) 0301-2603 (Linking)
Abstract:		"Direct surgical management of giant or large cerebral aneurysms remains one of the most challenging topics in the neurosurgical field. Surgical results have remained unsatisfactory. We review 22 cases of large or giant aneurysms with intraluminal thrombus and/or atherosclerotic thickening of the aneurysmal neck that have received direct surgical management in our department during the period from 1984 to 1996. As initial symptoms, ten patients presented with mass effect, five with ischemic attack, and three with subarachnoid hemorrhage. Sixteen aneurysms were supratentorial and six were in the posterior fossa. Direct neck clipping was attempted in sixteen cases. Two giant basilar aneurysms among them were clipped under deep hypothermia with cardiac arrest. Simple trapping of the parent artery was performed in three aneurysms and trapping with bypass graft was also carried out in three aneurysms. Ten patients made an excellent clinical recovery. Eleven patients suffered mild to severe disability. One death resulted from brain stem infarction, not directly related with surgical management. Appropriate preoperative assessment and intraoperative management of the associated thrombus and atherosclerotic change of the aneurysmal neck are essential for obtaining acceptable surgical results of large or giant cerebral aneurysms"
Keywords:		Adult Aged Female Humans Intracranial Aneurysm/complications/*pathology/*surgery Intracranial Arteriosclerosis/complications/*pathology Intracranial Embolism and Thrombosis/complications/*pathology Male Middle Aged Treatment Outcome;
Notes:		"MedlineUede, T Ohtaki, M Tanabe, S Hashi, K jpn English Abstract Japan 1997/12/05 No Shinkei Geka. 1997 Nov; 25(11):1007-15"