Hernesniemi J, Tapaninaho A, Vapalahti M, Niskanen M, Kari A, Luukkonen M
Department of Neurosurgery, University Hospital of Kuopio, Finland.
Neurosurgery. 1992 Dec;31(6):994-8; discussion 998-9. doi: 10.1227/00006123-199212000-00002.
We report a series of 84 consecutive patients (41 women) with 92 distal anterior cerebral artery aneurysms (DACAA). All aneurysms were saccular. Four different locations of DACAAs were found: proximal, 5 aneurysms; frontobasal, 8; genu corporis callosi, 72; and distal, 7. Sixty-five patients presented with subarachnoid hemorrhage (SAH), the rest were incidental findings in patients with multiple aneurysms. Forty-five patients had single DACAAs. Multiple aneurysms (a total of 117) were found in 39 patients (46.4%), and DACAAs were responsible for SAH in 20 patients. Of the 65 patients with SAH, 54 underwent mainly early direct surgery, and 46 (85%) of these had good outcomes 1 year after surgery. Three patients remained severely disabled, and five patients (9%) died. All of the poor surgical results were obtained in patients with severe preoperative deficits. Exact measurements of DACAA sizes and necks were smaller than those of cerebral aneurysms in other locations. Aside from localization, microsurgery of these aneurysms presented no special difficulties, as compared with surgery of aneurysms in other locations.
我们报告了连续的84例患者（41名女性），共92个大脑前动脉远端动脉瘤（DACAA）。所有动脉瘤均为囊状。发现DACAA有4个不同位置：近端5个动脉瘤；额底部8个；胼胝体膝部72个；远端7个。65例患者表现为蛛网膜下腔出血（SAH），其余为在多发性动脉瘤患者中偶然发现。45例患者有单个DACAA。39例患者（46.4%）发现有多发性动脉瘤（共117个），20例患者的SAH由DACAA引起。在65例SAH患者中，54例主要接受了早期直接手术，其中46例（85%）术后1年预后良好。3例患者仍严重残疾，5例患者（9%）死亡。所有手术效果不佳的患者术前均有严重功能缺损。DACAA大小和瘤颈的精确测量值小于其他部位的脑动脉瘤。除定位外，与其他部位动脉瘤手术相比，这些动脉瘤的显微手术并无特殊困难。
