Orz Y I, Hongo K, Tanaka Y, Nagashima H, Osawa M, Kyoshima K, Kobayashi S
Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
Surg Neurol. 2000 Jan;53(1):21-7; discussion 27-9. doi: 10.1016/s0090-3019(99)00171-8.
With the widespread use of less invasive imaging tools, such as magnetic resonance angiography and computed tomographic angiography, unruptured cerebral aneurysms are found much more often than in the past. This retrospective study was undertaken to determine the risk factors for surgical intervention in a patient with an unruptured intracranial aneurysm.
Over a 5-year period, 1,558 patients with intracranial aneurysms underwent surgery at our center. Of these, 310 patients (20%) with unruptured aneurysms were included in this study.
Out of 310 patients with unruptured aneurysms, 292 (95%) had a favorable outcome, and only one patient (0.3%) with a giant vertebral artery aneurysm died. Aneurysm size larger than 15 mm and location of the aneurysm in the posterior circulation were independent risk factors associated with less favorable outcomes. Patients with a single aneurysm had a better outcome than did patients with multiple aneurysms.
Our results support the contention that surgical treatment of unruptured intracranial aneurysms carries a low risk of morbidity and mortality and may improve the outcome in patients harboring cerebral aneurysms by preventing the devastating effects of subarachnoid hemorrhage. Aneurysm size, location, and number were risk predictors for surgical morbidity in patients with unruptured aneurysms.
随着磁共振血管造影和计算机断层血管造影等微创成像工具的广泛应用，未破裂脑动脉瘤的发现比过去更为频繁。本回顾性研究旨在确定未破裂颅内动脉瘤患者手术干预的危险因素。
在5年期间，1558例颅内动脉瘤患者在我们中心接受了手术。其中，310例（20%）未破裂动脉瘤患者纳入本研究。
在310例未破裂动脉瘤患者中，292例（95%）预后良好，仅1例（0.3%）巨大椎动脉动脉瘤患者死亡。动脉瘤大小大于15mm以及动脉瘤位于后循环是与预后较差相关的独立危险因素。单发动脉瘤患者的预后优于多发动脉瘤患者。
我们的结果支持这样的观点，即未破裂颅内动脉瘤的手术治疗具有较低的发病率和死亡率风险，并且通过预防蛛网膜下腔出血的破坏性影响，可能改善脑动脉瘤患者的预后。动脉瘤大小、位置和数量是未破裂动脉瘤患者手术发病率的风险预测因素。
