Surgical aspects for clipping arterial aneurysms of the middle cerebral artery
Objective – to improve the methods of surgical treatment arterial aneurysms (AA) of the middle cerebral artery (MCA).
Materials and methods. This work is performed on the material of 112 patients with MCA aneurysms. Patients were treated at Academician A.P. Romodanov Neurosurgery Institute in the period from 2012 to 2015. The age of patients – from 32 to 72 years, the mean age of patients was (49.3 ± 2.5) years. Most of the patients (66.7 %) were in the age group 41-60 years. Concerning the results, they were evaluated according to the radical exclusion of AA MCA from the blood flow at different periods of hemorrhage.
Results. In 95.7 % patients operated during the acute period of hemorrhage, a total exclusion of aneurysms has been achieved. The differences for total clipping of AA MCA in different periods of rupture and in its absence were statistically insignificant (p > 0.05).
Conclusions. Criteria for choosing to perform microsurgical treatment MCA AA are morphometric criteria for wide neck aneurysms, the ratio of the neck to the body 1:3, the size of AA less than 3 mm, the presence of intracerebral hematoma with the existing mass effect, the incorporation one of the branches of the MCA into the wall of the dome AA. It is also necessary to take into the general criteria of neurosurgical data, depending on the general condition of the patient, the clinical course of the disease, topographic and anatomical X-rays features of the structure of AA, taking into account these neuroimaging methods (CT, CTA, DSA).
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