脳底動脈上小脳動脈分岐部動脈りゅう５８手術例の検討

概要

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To contribute to a better understanding of the clipping operation of the basilar superior cerebellar aneurysm, we analyzed clinical symptom and factors influencing the surgical outcome in 58 patients. The patients were aged 22-78 years, with a mean age of 56 years, and there were 36 women and 22 men. Forty-four patients had been admitted because of subarachnoid hemorrhage, and a basilar superior cerebellar aneurysm ruptured in 36 patients. The size of the aneurysms ranged between 2 and 25 mm with a mean of 7 mm. The height of the aneurysm neck was between -5 and 15 mm measured above a biclinoid line with a mean of 7 mm. The pterional approach was utilized in 52 patients and subtemporal in 6 patients. Surgical outcome (Glasgow Outcome Scale) at 3 months after the operation was good recovery in 37 (64%), moderately disabled in 12 (21%), severely disabled in 2 (3%), vegetative survival in 5 (9%) and dead in 2 (3%). The aneurysm size and height of the neck proved to be preoperative factor, which significantly correlated with the surgical outcome. Damage or obliteration of the perforator during clipping surgery mainly resulted in a poor outcome.
一般社団法人日本脳卒中の外科学会の論文