Classification and Treatment of Aneurysms of the Vertebro-Basilar System
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概要
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In continuation of my concept of classification of ICA-system aneurysms the classification of the vertebro-basilar-system aneurysms is presented. The classification takes into consideration the variability and anomalies of the vessels and the site and projection of the aneurysm. The aim of this classification is to improve the preoperative topographic diagnosis and the choice of approach. The operative management has been pioneered by one man : C. G. Drake, who described the technique in detail on hand of his enormous experience with 469 aneurysms of the vertebro-basilar system. The necessity of a "normal aneurysm neurosurgeon" treating such aneurysms requires certain modifications of indication, approach and dissection. Experience with microsurgical technique of management of aneurysms is absolutely necessary.<BR> Transoral, transclival access facilitates the direct isolation of the aneurysm at the difficult border level of the lower clivus and should become a routine similarly to the transsphenoidal operation. <I>Electrothermic dissection</I> of the aneurysm diminishes the risk of rupture during the isolation of the sack and facilitates the isolation of the neck.<BR> The statistics of Drake provide full data for the prognosis of these aneurysms. It is to note that in the recent time the results reported from different centers in which aneurysmal surgery is performed became more and more similar. The embolization of large bulbous or spheric and giant aneurysms by inflatable balloon-technique possibly may replace the risky direct or indirect operations.
- 日本脳神経外科学会の論文
- 1979-07-15