Aneurysms of the Posterior Cerebral Artery: Retrospective Review of Surgical Treatment

概要

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A series of 10 cases of posterior cerebral artery (PCA) aneurysms were retrospectively reviewed. There were five men and five women aged 38 to 68 years (mean 57.5 years). Seven patients presented with subarachnoid hemorrhage. Two aneurysms were found incidentally during clinical examination for stroke. One aneurysm was associated with moyamoya disease. All aneurysms were saccular. The aneurysms arose from the P_1 segment in three patients, the P_1/P_2 junction in three patients, the P_2 segment in three patients, and the P_3 segment in one patient. Two patients died before operation and one patient refused surgery. Aneurysmal clipping was performed for seven patients. All aneurysms except the P_2 and the P_3 aneurysms were treated via the pterional approach. Four patients had excellent outcome, but one patient with a P_3 aneurysm developed homonymous hemianopsia due to thrombosis of the parent vessel and another patient with a P_2 aneurysm had moderate disability from the initial insult. Coil embolization has been indicated as the first choice of therapy, but PCA aneurysms are good candidates for direct clipping.
日本脳神経外科学会の論文
2004-04-15