Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
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Endovascular or Microsurgical Treatment of Ruptured Distal Anterior Cerebral Artery Aneurysms : Clinical Outcomes and Technical Considerations

  • Koh, Hack Cheol (Department of Neurosurgery, Kyung Hee University Hospital at Gangdong) ;
  • Koh, Jun Seok (Department of Neurosurgery, Kyung Hee University Hospital at Gangdong) ;
  • Lee, Seung Hwan (Department of Neurosurgery, Kyung Hee University Hospital at Gangdong) ;
  • Lee, Sun Joo (Department of Neurosurgery, Kyung Hee University Hospital at Gangdong) ;
  • Kim, Gook Ki (Department of Neurosurgery, Kyung Hee University Hospital at Gangdong) ;
  • Lim, Young Jin (Department of Neurosurgery, Kyung Hee University Medical Center Seoul)
  • Published : 2011.09.30
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Abstract

Objective : To analyze the clinical characteristics and outcomes of ruptured distal anterior cerebral artery (DACA) aneurysms and to discuss optimal treatment strategy. Methods : Out of 488 patients with ruptured intracranial aneurysms, 24 were treated for DACA aneurysms between February 2001 and January 2009. The medical records, radiological data and outpatient clinic charts of these patients were retrospectively reviewed. Results : The 24 patients (6 men, 18 women) had a mean age of 52 years (range, 30-70). Among the 24 patients, 6 underwent coiling and 17 underwent clipping. Fifteen patients had a Hunt-Hess grade of II, 5 with III 3 with IV and 1 had a grade of V. Nine patients had a Fisher grade of II, 1 with III and 14 had a grade of IV. Twenty-one (88%) patients had a good clinical course after treatment with endovascular (5 of 6 patients, 83%) or surgical (16 of 18 patients, 89%) treatments. Nineteen of 20 patients (95%) with good preoperative states (Hunt-Hess grade I-III) and 2 of the 4 patients (50%) with poor preoperative states (Hunt-Hess grade IV and V) demonstrated good clinical outcomes with Glasgow Outcome Scale (GOS) scores of 4-5. Two patients (8%) died due to pneumonia or preoperative severe brain damage. Conclusions : Acceptable and favorable outcomes were achieved in patients with good preoperative states who were treated with either clipping or coiling of ruptured DACA aneurysms. Immediate and active treatment should be mandatory for favorable outcomes.

Keywords

References

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