Summary
The surgical approach to cerebral giant aneurysms is still a source of great concern. We describe our experience with giant aneurysms of the anterior circulation and discuss the different surgical techniques adopted.
During the period January 1972–December 1985, a total of 33 patients were operated upon at the Istituto Neurologico “C. Besta” of Milan for a giant aneurysm of the anterior circulation. Nineteen cases had suffered subarachnoid haemorrhage before admission; in 14 cases the hospitalization was due to evidence of mass effect on the surrounding neurovascular structures. All aneurysms were directly approached: in 24 cases the neck was occluded by a suitable clip, in 4 cases intramural thrombosis was attempted, in 3 cases the aneurysms were definitively trapped and in one case aneurysmorrhaphy was performed after resection of the sac.
Operative mortality was 12%. Long-term follow-up shows good results whenever exclusion of the aneurysm from cerebral circulation had been achieved, either after removal of the sac or not; on the contrary, only fair or poor results were evident when other surgical techniques were adopted, either electively or out of necessity.
The importance of intraoperative protection and monitoring of brain function is stressed.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Drake CG (1979) Giant intracranial aneurysms: experience with surgical treatment in 174 patients. Clin Neurosurg 26: 12–95.
Gelber BR, Sundt TM Jr (1980) Treatment of intracavernous and giant carotid aneurysms by combined internal carotid ligation and extra-to intracranial bypass. J Neurosurg 52: 1–10.
Carlson DH, Thomson D (1976) Spontaneous thrombosis of a giant cerebral aneurysm in five days. Report of a case. Neurology 26: 334–336.
Heiskanen O, Nikki P (1962) Large intracranial aneurysms. Acta Neurol Scand 38: 195–208.
Hosobuchi Y (1979) Direct surgical treatment of giant intracranial aneurysms. J Neurosurg 51: 743–756.
Jain KK (1965) Surgery of intracranial berry aneurysms. A review. Can J Surg 8: 172–187.
Morley TP, Barr HWK (1969) Giant intracranial aneurysms: diagnosis, course, and management. Clin Neurosurg 16: 73–94.
Mullan S (1974) Experiences with surgical thrombosis of intracranial berry aneurysms and carotid cavernous fistulas. J Neurosurg 41: 657–670.
Onuma T, Suzuki J (1979) Surgical treatment of giant intracranial aneurysms. J Neurosurg 51: 33–36.
Sindou M, Keravel Y (1984) Les anévrysmes géants intracrâniens. Approches thérapeutiques. Neurochirurgie 30 [Suppl] 1.
Sonntag VKH, Yuan RH, Stein BM (1977) Giant intracranial aneurysms: a review of 13 cases. Surg Neurol 8: 81–84.
Sundt TM Jr, Piepgras DG (1979) Surgical approach to giant intracranial aneurysms. Operative experience with 80 cases. J Neurosurg 51: 731–742.
Symon L, Vajda J (1984) Surgical experience with giant intracranial aneurysms. J Neurosurg 61: 1009–1028.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1988 Springer-Verlag/Wien
About this paper
Cite this paper
Giombini, S., Solero, C.L., Ferraresi, S., Melcarne, A., Broggi, G., Pluchino, F. (1988). Surgical Approach to Giant Aneurysms of the Anterior Circulation. In: Isamat, F., Jefferson, A., Loew, F., Symon, L. (eds) Proceedings of the 8th European Congress of Neurosurgery Barcelona, September 6–11, 1987. Acta Neurochirurgica Supplementum 42, vol 42. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8975-7_14
Download citation
DOI: https://doi.org/10.1007/978-3-7091-8975-7_14
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-8977-1
Online ISBN: 978-3-7091-8975-7
eBook Packages: Springer Book Archive