수술을 시행한 비파열 뇌동맥류의 임상적 분석

Abstract

Objective : Greater availability and improvement of neuro-radiological technique have resulted in more definite and frequent detection of unruptured aneurysms. Because the prognosis of subarachnoid hemorrhage is still unfavorable, preventive surgery is considered as a better therapeutic option. However, it should be more important to figure out what the appropriate therapeutic direction is in treating unruptured aneurysms. Methods : We studied 46 patients who underwent surgical treatments of unruptured aneurysms. Informations regarding aneurysm size, location, and surgical outcome were gathered retrospectively from Jan. 2000 to May. 2005. We excluded those with aneurysm size of less than 3mm, and patients who were older than the age of 75, except a case of 78 year-old relatively healthy male patient. Results : In our series, male to female ratio is 19:27. The mean patient age was 63 years old, and the mean lesion size was 8.5mm. Locations of the lesions included the Internal carotid artery(ICA, 47%), Middle cerebral artery(MCA, 23%), Anterior communicating artery (AcoA,13%), Anterior cerebral artery (ACA, 8%) and Vertebrobasilar artery(VA-BA, 6%). Multi-variable anaylsis revealed that aneurysm size and vertebrobasilar location were independently associated with the high risk of poor outcome or death. Conclusions : After adequately analyzing the age of the patients, locations of the aneurysms, general health states of the patients and the ratio between the surgical technique and advantages regarding invasive procedures, appropriate treatment methods should be selected with knowledges about the nature of unruptured aneurysms, mortality and prevalence rate due to such cerebral hemorrhage.