Clinical Outcome of Surgery for Unruptured Intracranial Aneurysms.

Rhee, Deok Joo; Hong, Seung Chyul; Kim, Jong Hyun; Kim, Jong Soo

Original Article

Journal of Korean Neurosurgical Society 2006;40(4): 227-233.

Deok Joo Rhee, Seung Chyul Hong, Jong Hyun Kim, Jong Soo Kim

Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jskim@smc.samsung.co.kr

ABSTRACT

OBJECTIVE
To determine the rationale for treating pure unruptured intracranial aneurysms(UIAs), it is mandatory to know the risk of each treatment modality. The purpose of this study is to evaluate the surgical risk for treating UIAs.
METHODS
Between December 1994 and May 2005, 147 unruptured aneurysms in 135 patients were treated. The majority of these cases (94.6%) were treated with aneurysmal neck clipping. The remainder received aneurysmal wrapping (2.7%), trapping with bypass (2.0%), or proximal occlusion (0.7%). The clinical outcomes were evaluated in each patient by the Glasgow Outcome Scale at one month post-surgery.
RESULTS
The patient pool consisted of 41 males and 94 females. The mean age was 55.9 years (range: 16~82). The aneurysms were located at middle cerebral artery in 63 (42.9%), anterior communicating artery 30 (20.4%), posterior communicating artery in 26 (17.7%), internal carotid artery(ICA) in 14 (9.5%), anterior choroidal artery in 4 (2.7%) and others in 10 (6.9%). One hundred fifteen (78.2%) of aneurysms were small (<10mm). Others were large (10 to 25mm) and giant (>25mm); 29 (19.7%) and 3 (2.1%) respectively. More than ninety percent (91.1%) of all patients recovered well. Mild to severe disability was seen in 8.7% of the patients. One patient succumbed to complications following injury to the ICA.
CONCLUSION
The mortality and morbidity associated with UIA surgery at our hospital compared very favorably to the previous reported literature and with the previously established natural history of this disease.

Key Words: Unruptured intracranial aneurysm; Surgical treatment; Outcome; Complication