Characteristics of the Morphology, Clinical Features, Diagnosis, and Treatment of Patients with Giant Aneurysms of the Brain Vessels

Abstract

We report here a retrospective analysis of the results of treatment of 89 patients with giant aneurysms (GA) of the brain vessels. A total of 67 patients underwent surgery, with open surgery performed in 49 cases and endovascular procedures in 18. The severity of patients’ status was assessed on the Hunt–Hess scale, levels of consciousness on the Glasgow Coma Scale, and treatment results on the Glasgow Outcomes Scale. Four types of course were identified for aneurysm: apoplectiform in 64 patients (72.0%), pseudotumorous in 18 patients (20.2%), embolic in three patients (3.4%), and asymptomatic in four patients (4.4%). Excellent and good results from surgery were obtained in 79.1% of patients; post-operative lethality was 13.4%. Among unoperated patients with symptomatic GA, lethality was 47.4%. These results lead to the conclusion that although open and endovascular interventions for GA represent highrisk surgery, surgery is preferable to conservative treatment, as it decreases lethality and leads to better functional outcomes.