Tratamento cirúrgico de aneurismas intracranianos

Abstract

The author reviews his personal experience in the surgical treatment of 325 patients presenting intracranial aneurysms. The patients were operated at Cristo Redentor Hospital between January 1979 and December 1986. Pre and post surgical management of sub-arachnoid haemorrhage and its complications is described. Internal carotid aneurysms were 122; anterior carotid artery, 100; middle cerebral artery, 69; vertebro-basilar system, 4; and multiple aneurysms, 30. 321 of those aneurysms were approached directly. 177 patients Grade I were surgically treated, with a mortality rate of 5.08%; 78 in Grade II with mortality rate of 16.66%; 55 in Grade III with mortality rate of 36.36%; and 15 in Grade IV with mortality rate of 66.6%. The general mortality rate was 16%. The results of surgeries in the former group (1961-1978) of 277 patients were compared to the group of 325 cases. The final mortality rate in 552 operated patients in the two groups is 18.11%.

Aneurisma paraclinóideo: técnica cirúrgica e resultados em 51 pacientes

“…Na presente casuística, a incidência de 6.5% em relação ao conjunto dos aneurismas cerebrais, a ocorrência de aneurismas múltiplos em 18% dos casos e a predominância no sexo feminino, na proporção de 4.1: 1 está em consonância com a literatura 30 .A maioria dos aneurismas do segmento oftálmico da ACI se origina da parede superomedial da ACI, pró-ximo ou junto à origem da artéria oftálmica estando, portanto, lateral ao nervo óptico 1 . Entretanto, alguns aneurismas deste segmento (especialmente os pequenos) não têm nenhuma correlação com a artéria oftálmica, pois estão localizado mais ínfero-medialmente, na circunferência da ACI 6 , ou em outros locais da ACI 11,31 .…”