Abstract
両側性対称性中大脳動脈瘤の破裂側を,術前に特定できた割合は91.7%であった.手術術式の決定には,「CTと脳血管造影所見のlateralityをもとにした3群分類」が有用であった.第1群はCTで出血の左右差がある群,第2群はCTで左右差はないが脳血管造影所見に明らかな差がある群,第3群はCTと脳血管造影で左右差がない群である.第1群と第2群は,片側開頭で破裂動脈瘤を手術し,未破裂動脈瘤は後日に手術を行った(two-stage operation).第3群では,両側開頭で左右の動脈瘤を一期的に手術した(one-stage operation).CTと脳血管造影所見に"discrepancy"のある場合は,動脈瘤内の血栓化の可能性を考えるべきである.
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