[Surgical treatment of the internal carotid-posterior communicating artery aneurysm--from the experience of 213 cases (author's transl)].

213 cases of so-called posterior communicating artery aneurysm submitted to surgical operation without using microscope were reviewed from the technical point of view. Aneurysm project boradly to two directions, i.e. postero-inferior and lateral directions. We have treated these anuerysms with two very distinct operative approaches in order to reach the aneurysmal neck from the right angle. Frontal approach is used for the aneurysms projecting laterally. In contrast, the aneurysms projecting postero-inferior are reached laterally by mobilizing the tip of the temporal lobe. Of 213 patients, 15 died (mortality rate 7.0%) and 19 were poor (8.9%). The operative result of the cases in which the aneurysm ruptured during the exposure of the aneurysmal neck was poor. Therefore, intensive care is emphasized to avoid the aneurysm rupture during surgery. Other important technical points which affect the operative results were discussed.