[Surgical prognosis of unruptured intracranial arterial aneurysms. 50 cases]

The authors have reviewed a series of 53 patients with unruptured intracranial arterial aneurysm. Out of 50 patients operated upon, 2 died post-operatively, 5 remained with neural deficits that were present before surgery, and 43 were cured without subsequent cerebral or meningeal haemorrhage. None of the 3 unoperated patients developed cerebral vascular accidents. In 25 cases the aneurysm was asymptomatic and was discovered accidentally during angiography; it varied in size from 3 to 6 mm. In 28 cases, the aneurysm gave rise to various symptoms, including headache or facial pain (9 cases), ischaemic vascular accident (7 cases), ocular symptoms (8 cases), seizures (4 cases); its size ranged from 7 to 10 mm. The clinical and post-mortem series available in the literature show the usefulness of surgery in patients presenting with factors that increase the risk of rupture, i.e.: age comprised between 40 and 65 years, history of arterial hypertension, aneurysm located on the anterior segment of Willis' circle and about 10 cm in diameter, which is the critical size for rupture.