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The authors bring out their statistics of 16 cerebral arterial aneurysms, in 5 years (nine women, between 31 and 68 years, and seven men between 30 and 54 years) .Eleven patients had presented repeated subarachnoid hemorrhage (9 episodes going back as far as 15 years for one of them) five various ocular paralysis and four hemiplegias. Another patient had an isolated paralysis of the third nerve and trigeminal neuralgia, two others a syndrome of the cavernous sinus. One man presented an isolated comitiality and the last patient a whole ophthalmoplegia after a severe cranial traumatism.In all those patients, arteriography shows the supra (11) or infra-clinoid (5) location of the aneurysm, generally bag-shaped and pea-sized.After a sufficient Matas test, 14 patients were treated by a carotid ligation; 8 ligations of the common carotid (six of them being complete or with arterial resection and two incomplete with fascia lata strip), 6 ligations of the internal carotid (5 complete and 1 incomplete). Among the complete ligations of the internal carotid, four hemiplegias occurred, one at the 17th minute, having disappeared after the ligature had been taken off, necessitating partial ligation, two others in a few hours following the procedure. The last one died the third day after the operation. As for the ten other patients, 6 had no recurrence of subarachnoid hemorrhage, 3 saw their paralytic ocular disorders getting better, one has been lost to view.The authors insist on the necessity of a control of the arterial channels by bilateral arteriography, the measure of the ocular pressure, and the preoperative E.E.G. and on the dangers of anticoagulant therapy. All those precautions were used in the 4 last patients of that series which did not prevent the hemiplegia in the post-operative stage of one case.Only two patients were submitted to a direct approach to the aneurysm; one, 42 years old, died on the fourth day, of a massive softening; the other, 46 years old, died of a profuse hemorrhage a few hours following the procedure.This series intends to show the efficiency and the relative mildness of ligation compared with the gravity of the direct approach.34 Rue Duquesne

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