Abstract
Saccular aneurysms rupture at the fundus. An aneurysm can be isolated from the circulation most easily if its fundus is not disturbed. Internal carotid aneurysms may project in many directions. Review of 100 consecutive cases reveals that just less than one fourth of these aneurysms project laterally over the tentorial edge into the tip of the temporal lobe. Two distinct surgical approaches are recommended on the basis of this classification. The aneurysms are also analyzed with regard to size, site of origin and configuration of the circle of Willis. There is an increased incidence of embryonic branching of the internal carotid artery in those patients with posterior communicating aneurysms suggesting a haemodynamic factor in the pathogenesis of cerebral aneurysms.
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