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Surgical Exclusion of Unruptured Middle Cerebral Artery Aneurysms: Experience of 126 Cases

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Trends in Neurovascular Interventions

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 119))

Abstract

A group of 126 surgical patients with 143 unruptured MCA aneurysms was evaluated in order to determine the risks of treatment and possible adjuncts for safer surgery. The precise location and size of the aneurysms were determined in each case; 21 aneurysms were located on the M1 tract, 109 on the main division – which consisted of more than two branches in 10 cases and was proximally located in 12 cases – and 13 were distal; 36 aneurysms were small (<7 mm), 90 standard, and 17 large or giant (>15 mm); 45 patients harbored multiple aneurysms (12 on the ipsilateral MCA). The aneurysms were excluded by clip in most cases, with the assistance of intraoperative flowmetry in 78 patients. Temporary proximal vessel occlusion was used in 57 patients (>10 min in 8 cases), without significant effects on radiological or clinical outcome. After surgery, newly occurring minor deficits were observed in 5 patients and significant deficits in 4; one patient died from an intractable coagulopathy. The low rate (3.9 %) of unfavorable results (modified Rankin Score > 2) linked to surgery justifies serious consideration for treatment in these patients, especially when facing the high disability rate after the rupture of aneurysms in this anatomical location.

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Conflict of Interest Statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Institute of Neurosurgery and Section of Vascular Neurosurgery, Verona City Hospital, Via Milazzo, 2, Verona, 37128, Italy

    A. Pasqualin, P. Meneghelli, F. Cozzi & A. Giammarusti

Authors
  1. A. Pasqualin
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  2. P. Meneghelli
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  3. F. Cozzi
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  4. A. Giammarusti
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Corresponding author

Correspondence to A. Pasqualin .

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Editors and Affiliations

  1. Dept. of Neurosurgery, Kyoto Medical Center, Kyoto, Japan

    Tetsuya Tsukahara

  2. Klinik für Neurochirurgie UniversitätsSpital Zürich, Zürich, Switzerland

    Giuseppe Esposito

  3. Neurochirurgische Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany

    Hans-Jakob Steiger

  4. Department of Neurology, University Medical Centre Utrecht, Utrecht, The Netherlands

    Gabriel J.E. Rinkel

  5. Klinik für Neurochirurgie UniversitätsSpital Zürich, Zürich, Switzerland

    Luca Regli

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Pasqualin, A., Meneghelli, P., Cozzi, F., Giammarusti, A. (2014). Surgical Exclusion of Unruptured Middle Cerebral Artery Aneurysms: Experience of 126 Cases. In: Tsukahara, T., Esposito, G., Steiger, HJ., Rinkel, G., Regli, L. (eds) Trends in Neurovascular Interventions. Acta Neurochirurgica Supplement, vol 119. Springer, Cham. https://doi.org/10.1007/978-3-319-02411-0_4

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  • DOI: https://doi.org/10.1007/978-3-319-02411-0_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-02410-3

  • Online ISBN: 978-3-319-02411-0

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