未破裂脳動脈瘤クリッピング術後の中期予後(<特集>脳卒中治療の中・長期予後)

概要

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We investigated surgical immediate and semi-long-term results of the unruptured aneurysms in 113 patients. Between 1992 and 2000, we operated 110 unruptured anterior circulation aneurysms and 3 unruptured posterior circulation aneurysms. The mean age was 57.7 years, mean aneurysm size was 7.0 mm, and mean follow-up period was 4.7 years. Surgical complication was judged at 6 months, and patients with worsening of Modified Rankin Score of more than II were considered surgical morbidity. Patients were subsequently followed to clarify the occurrence of subarachnoid hemorrhage, aneurysm regrowth and occurrence of stroke other than subarachnoid hemorrhage. Surgical mortality was noted in 1 patient (0.9%), and morbidity was noted in 4 patients (3.5%). Subarachnoid hemorrhage after clipping surgery was noted in 1 patient, accounting for 0.19% /year of occurrence. One patient had recurrence of aneurysms and another had de novo aneurysms. The rate of occurrence of aneurysms after clipping of the unruptured cerebral aneurysms was at least 0.56%/year. Six cases had stroke other than subarachnoid hemorrhage. Especially patients whose aneurysm was found during investigation of ischemic stroke had recurrent ischemic disease at a rate of 4.5%/year. These results indicate the necessity of long-term observation of patients previously treated for unruptured aneurysm.
日本脳卒中の外科学会の論文
2002-03-31