The microsurgical treatment patient with 21 cases of anterior circulation aneurysms by pterional approach

Abstract

Objective To investigate the related issues on surgical treatment of anterior circulation aneurysms by pterion approach. Methods 21 patients were diagnosed with intracranial anterior circulation aneurysms by CTA or DSA, and were treated by micro-surgery of pterion approach, the clinical data on 21 patientswas analysed retrospectively, and surgical timing and short-term effect was evaluated. Results The results of preoperative Hunt-Hess grade respectively is grade Ⅰ in 7 patients, grade Ⅱ 9 cases, grade Ⅲ 4 cases, grade Ⅳ 1 cases. The 21 patients were taken operations successfully ,4 aneurysms ruptured and bleeded during operations.Followed-up for 2 ～ 12 months, 16 cases were in good ,3 cases was light residual, 1 case was severe disability and 1 case was dead. According to Short-term effect on this group ,the good rate was 85.8% (20/21), the mortality was 6. 6% ( 1/21 ), the intraoperative rupture rate was 19. 05 % (4/21 ). Conclusion The patient with anterior circulation aneurysm in Hunt-Hess grade Ⅰ～Ⅲ should be taken an operation as soon as possible, the pterional approach is the classical approach in the treatment of anterior circulation intracranial aneurysms, the controlled hypotension can increase the safety of operation, the skillful microsurgical technique involves guarantee of successful surgery. Key words: Intracranial aneurysms; Micro-surgery; Pterional approach