Pre- and postoperative psychiatric symptoms were compared in 85 patients with anterior communicating aneurysms and 73 of these cases were followed up to determine the long-term results. Psychiatric symptoms of varying severity were present preoperatively in 61 % of the cases, which decreased to 34 % after surgery. Use of the microsurgery microscope resulted in a no change: aggravation:mortality ratio of 27:5:0, as compared with 33:20:4 when the microscope was not used.

We are reporting an unusual case of a giant serpentine aneurysm of the posterior cerebral artery (PCA). We were unable to find a report in the literature of a similar aneurysm. The microsurgical pterional approach was used for temporary clipping of the P-2 segment of the PCA, and the aneurysm was trapped successfully and excised. The discussion includes the operative approach to the giant serpentine aneurysm.

SummaryThree cases with unusual complications of shunting procedures are reported. These were migration of the peritoneal catheter into the mediastinum following an operation for a ventriculoperitoneal (VP) shunt, extrusion of the peritoneal catheter through a well-healed abdominal incision in an adult following a VP shunt operation, and migration of the subdural catheter into the brain substance causing increased intracranial pressure following a subduroperitoneal shunt operation. The possible mechanisms leading to the two migrations and the extrusion are discussed.

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