Connolly E S, Solomon R A
Department of Neurological Surgery, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
Neurosurg Clin N Am. 1998 Jul;9(3):509-24.
Intradural unruptured saccular aneurysms are being diagnosed with increasing frequency. Left untreated, these lesions usually progress, and the cumulative risk from bleeding usually outweighs the risk of treatment. Exceptions include patients with limited life expectancy and patients over the age of 70 with small asymptomatic or giant posterior circulation lesions associated with few symptoms. Therapeutic intervention offers little over the natural history for these patients, and therapy should be considered only if symptoms progress or growth is documented. Treatment options should be coordinated by an experienced cerebrovascular surgeon with access to interventional adjuncts; EC-IC bypass, and circulatory arrest. GDC coiling should be reserved for non-surgical cases, as the durability of this treatment is still being evaluated.
硬脊膜内未破裂的囊状动脉瘤的诊断频率越来越高。如果不进行治疗，这些病变通常会进展，出血的累积风险通常超过治疗风险。例外情况包括预期寿命有限的患者以及70岁以上、患有小的无症状或巨大后循环病变且症状较少的患者。对于这些患者，治疗干预与自然病程相比益处不大，仅当症状进展或有生长记录时才应考虑治疗。治疗方案应由经验丰富的脑血管外科医生协调，他们应能获得介入辅助手段、颅外-颅内搭桥术和循环停止技术。GDC栓塞术应保留用于非手术病例，因为这种治疗的持久性仍在评估中。
