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Screening and treatment of unruptured cerebral aneurysms
Insights
Operative treatment for unruptured cerebral aneurysms is advocated due to low risk. Surgical intervention for select patients with unruptured brain aneurysms offers protective benefits against rupture.
Area of Science:
- Neurosurgery
- Neurology
- Vascular Neurology
Background:
- Unruptured cerebral aneurysms pose a risk of subarachnoid hemorrhage.
- Management decisions for unruptured aneurysms require careful consideration of risks and benefits.
Purpose of the Study:
- To analyze outcomes of surgical versus non-surgical management of unruptured cerebral aneurysms.
- To evaluate the safety and efficacy of operative treatment for select patients.
Main Methods:
- Retrospective analysis of 30 outpatients with unruptured cerebral aneurysms.
- Computed angiotomography for screening and follow-up.
- Comparison of outcomes between operated and non-operated patients.
Main Results:
- Fifteen patients underwent successful surgery with transient post-operative complications in three.
- Fifteen non-operated patients showed no change in eight, with six experiencing worsening or death from other causes.
- One patient died from aneurysm rupture five months after detection.
Conclusions:
- Operative treatment for carefully selected unruptured cerebral aneurysms is recommended due to low operative risk.
- Surgical intervention can provide a protective benefit against initial subarachnoid hemorrhage.
- Individualized patient selection is crucial for optimizing outcomes in unruptured aneurysm management.
Abstract:
Thirty outpatients with unruptured cerebral aneurysms screened by computed angiotomography have been analysed and followed up in our clinic since 1979. Seventeen were men and the age range was 41 to 74 years old (mean 57.7 years). Patients had no or only mild neurological symptoms, such as headache, sensorimotor or speech impairment and others, which were scarcely related to the unruptured aneurysms themselves. It is important to realize that these first aneurysms which remain unruptured, have a primary significance to the individual in the protective aspect of an initial subarachnoid haemorrhage. Operation was successfully performed in fifteen patients. Transient aggravation of previous diseases, e.g. cerebral infarction, occurred in three after operation. Follow-up studies of fifteen patients without operation revealed no change in eight and some worsening or death due to other or previous diseases in six. One died of aneurysmal rupture in the 5th month after its detection. Because of the low operative risk, we advocate the operative treatment of unruptured aneurysms, following careful selection of the indicated patients.