Microsurgical Effect Of Middle Cerebral Artery Aneurysm

Objective To explore the clinical characteristics, neuroradiological manifestation, microsurgical technique and clinical effectiveness of middle cerebral artery (MCA) aneurysms.Methods The clinical data of202cases with MCA aneurysms by microsurgical clip-ping operated in Affiliated Hospital of Qingdao College between1997April and2013Decembey were studied retrospectively. According to Hunt-Hess classification,11cases of grade0(5.4%)、11cases of grade Ⅰ(5.4%)、78cases of grade Ⅱ(38.6%)、67cases of gradeⅢ(33.2%)、31cases of gradeⅣ(15.4%)、4cases of gradeⅤ(2.0%);100cases were clear (49.4%),67cases were light coma patients (33.2%),31cases were coma in moderate depth(15.4%),4cases were deep coma(2.0%).CT examination was performed in all the202patients.85cases took a definite diagnosis by DSA (42.1%),88cases by CTA (43.6%),5cases by MRA (2.5%),5cases by DSA and CTA (2.5%),2cases by DSA and MRA (1.0%), and in which16cases were per-formed emergency operation becase of severe ill (7.9%).202patients were found242aneurysms. The lesion were solitary in168cases (83.2%) a total of168anerrysms. Multiple in34cases (16.8%) a total of74aneuysms. The MCA215,in addition to a failed to break the MCA first embolism,the remaining214MCA lines of craniotomy clipping212,autologous dural package2. Othet parts of27aneurysms, clipped successfully22,embolism1,autologous dural package1,3without clipping.Results According to GOS, surgical outcome was good in168cases(83.1%), life can take of themselves22cases(10.9%), severe disability or vegetative patient in6cases (3.0%) and6cases died(3.0%). According to effect:Good efficacy (cure and care) in190cases (94.0%),adverse effect (severe disability and death) in12cases (6.0%)。Conclusions A prominent effect can be received if microsurgical operative is performed on MCA aneurysms. Early and correct diagnosis with clinical characteristics and neuroradiological manifestation and good microsurgical technique are keys to the improvement of clinical effect.