Analysis Of 81 Cases Of Giant Intracranial Aneurysms: Clinical Treatment Strategies

Objective:To explore the treatment of giant intracranial aneurysm,share skills and experience during the operation,retrospective analysis of the different prognosis after these treatments,provide a reference for giant intracranial aneurysms during the individualized-treatment.Methods:We selects 89 cases of giant intracranial aneurysms admitted in 2006-2015 from Central Hospital of Da Lian.After preoperatively assessed the overall situation of the patient's gender,age and Hunt-Hess grade,we tried various treatments under the principle of individualized treatment.After the surgery,we record the postoperative complications as well as prognosis of the Glasgow Outcome Scale(GOS)to analysis the outcome of the different treatments.We bring the 1-year follow-up to most of these cases.The preliminary analysis on the above statistical results.Results:Results Of the 81 patients with GIA,2 patients after short-term treatment give up treatment because of economic factor,two cases of perioperative mortality(aneurysm re-bleeding in 1 case,severe ischemic infarction caused by hernia in 1case),77 patients take DSA exam before discharge.Common complications of these patients were recorded in 10 days o(bleeding,severe vasospasm,cerebral infarction,severe brain edema,intracranial infections and lung infections,hydrocephalus),as well as modified GOS(modified Glasgow Outcome scale)score and modified Rankin scale(modified Rankin scale)score.Conclusion:1.Four treatment schemes used are proved to be effective method for treatment of giant intracranial aneurysms.2.In view of the special location and morphological characteristics of giant intracranial aneurysms,although combination treatment comes with high economic cost,the operation reliability and safety during the operation are validated.Postoperative complications,the short-term and mid-term follow-up also showed obvious advantages.3.In priority to ensure the effective and reliable treatment of giant intracranial aneurysms principle,selecting relatively littler economic costtreatment(simple craniotomy clip closed or endovascular treatment)gets the support of patients and their families,but it needs adequate preoperative evaluation and higher operation skills.4.When the aneurysm characterized by special morphology(such as serpentine aneurysms)or special location,it may not be directly clipped or carry on endovascular treatment.If the patient is based in good condition,Poor performance of tolerance level in Mata test and collateral circulation assessment,some patients can carry on EIAB surgery according to different condition.