33. 脳梗塞に合併した脳動脈瘤の手術

概要

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Twenty of 51 cases of unruptured cerebral aneurysm experienced by the authors during the past 9 years were complicated with cerebral infarction. Clipping made on all of these 20 cases resulted in cerebral edema in 2 cases, postoperative convulsion in 5 cases and aggravated infarct symptoms due to exaggerated cerebral ischemia in 8 cases, as complicated postoperatively, as well as intracerebral hemorrhage in 6 cases. These postoperative complications led to 7 of 20 cases aggravated more or less than before operation, of these 7 cases 2 died. On the other hand, clipping was made on all of 31 cases of unruptured cerebral aneurysm detected concomitantly with other affections than cerebral infarction, which clipping, however, resulted in postoperative intracerebral hemorrhage in only one case.<BR>Considering that infarcted brain is apt to present aggravated infarct symptoms, edema and hemorrhage according to the operative procedure and that cases complicated with cerebral infarction have comparatively advanced ages and short life expectancy, it can be thought that unruptured cerebral aneurysm complicated with cerebral infarction should be defined with caution for its operative indication.
The Japanese Society on Surgery for Cerebral Strokeの論文