Skip to main content

Advertisement

SpringerLink
Log in

Characteristics of the Morphology, Clinical Features, Diagnosis, and Treatment of Patients with Giant Aneurysms of the Brain Vessels

  • Published:
Neuroscience and Behavioral Physiology Aims and scope Submit manuscript

We report here a retrospective analysis of the results of treatment of 89 patients with giant aneurysms (GA) of the brain vessels. A total of 67 patients underwent surgery, with open surgery performed in 49 cases and endovascular procedures in 18. The severity of patients’ status was assessed on the Hunt–Hess scale, levels of consciousness on the Glasgow Coma Scale, and treatment results on the Glasgow Outcomes Scale. Four types of course were identified for aneurysm: apoplectiform in 64 patients (72.0%), pseudotumorous in 18 patients (20.2%), embolic in three patients (3.4%), and asymptomatic in four patients (4.4%). Excellent and good results from surgery were obtained in 79.1% of patients; post-operative lethality was 13.4%. Among unoperated patients with symptomatic GA, lethality was 47.4%. These results lead to the conclusion that although open and endovascular interventions for GA represent highrisk surgery, surgery is preferable to conservative treatment, as it decreases lethality and leads to better functional outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. V. A. Lazarev, Clinical Features, Diagnosis, And Surgical Treatment of Large and Giant Saccular Brain Aneurysms: Author’s Abstract of Doctoral Thesis in Medical Sciences, Moscow (1995).

  2. V. V. Lebedev, N. S. Kuksova, V. V. Krylov, and M. Yu. Myatchin, “The informativeness of the EEG in the acute period of subarachnoid hemorrhage due to rupture of intracranial arterial aneurysms,” Vopr. Neirokhirurgii, No. 5, 44–49 (1989).

  3. V. V. Lebedev,V. V. Krylov, and V. N. Shelkovskii, Clinical Features, Diagnosis, and Treatment of Intracranial Arterial Aneurysms in the Acute Period of Hemorrhage [in Russian], Antidor, Moscow (1996).

    Google Scholar 

  4. H. Artmann, D. Vonofakos, H. Muller, and H. Grau, “Neuroradiologic and neuropathologic findings with growing giant intracranial aneurysms: review of literature,” Surg. Neurol., 21, 391–401 (1984).

    Article  PubMed  CAS  Google Scholar 

  5. J. L. D. Atkinson and D. G. Piepgras, “Giant aneurysms: supratentorial,” in: Neurovascular Surgery, L. P. Carter and R. E. Spetzler (eds.), McGraw Hill Inc. (1995), pp. 815–850.

  6. C. G. Drake, “Giant intracranial aneurysms: experience with surgical treatment in 174 patients,” Clin. Neurosurg., 26, 12–95 (1979).

    PubMed  CAS  Google Scholar 

  7. C. D. Hahn, D. A. Nicolle, S. P. Lownie, and C. G. Drake, “Giant cavernous carotid aneurysms: clinical presentation in fifty-seven cases,” J. Neuroophthalmol., 20, No. 4, 253–258 (2000).

    Article  PubMed  CAS  Google Scholar 

  8. E. F. Hauck, B. G. Welch, J. A. White, et al., “Stent/coil treatment of very large and giant unruptured ophthalmic and cavernous aneurysms,” Surg. Neurol., 71, No. 1, 19–24 (2008).

    Article  PubMed  Google Scholar 

  9. Y. Hosobuchi, “Direct surgical treatment of giant intracranial aneurysms,” J. Neurosurg., 51, 743–756 (1979).

    Article  PubMed  CAS  Google Scholar 

  10. Y. Kato, S. Imizu, et al., “Surgical strategies for treatment of giant or large intracranial aneurysms with 139 cases,” Minim. Invasive Neurosurg., 46, No. 6, 339–343 (2003).

    Article  PubMed  CAS  Google Scholar 

  11. M. T. Lawton and R. F. Spetzler, “Surgical strategies for giant intracranial aneurysms,” Acta Neurochir., 72, Supplement, 141–156 (1999).

    CAS  Google Scholar 

  12. T. P. Morley and H. W. K. Barr, “Giant intracranial aneurysms: diagnosis, course and management,” Clin. Neurosurg., 16, 73–94 (1969).

    PubMed  CAS  Google Scholar 

  13. H. Nakase, Y. Shin, Y. Kanemoto, et al., “Long-term outcome of unruptured giant cerebral aneurysms,” Neurol. Med. Chir. (Tokyo), 46, No. 8, 379–384 (2006).

    Article  Google Scholar 

  14. S. J. Peerless, M. C. Wallace, and C. G. Drake, “Giant intracranial aneurysms,” in: Neurological Surgery, J. R. Youmans (ed.), W. B. Saunders, Philadelphia, 3rd edition (1990), Vol. 3, pp. 1742–1763.

  15. H. W. Pia and J. Zierski, “Giant cerebral aneurysms,” Neurosurg. Rev., 5, 117–148 (1982).

    Article  PubMed  CAS  Google Scholar 

  16. W. Qi, S. Wang, Y. L. Zhao, et al., “Clinical characteristics and surgical treatment of patients with giant intracranial aneurysms,” Chin. Med. J., 121, No. 12, 1085–1088 (2008).

    PubMed  Google Scholar 

  17. R. F. Spetzler, H. A. Riina, and G. M. Lemole, “Giant aneurysms,” Neurosurgery, 49, 902–908 (2001).

    PubMed  CAS  Google Scholar 

  18. T. M. Sundt, Jr. and D. G. Piepgras, “Surgical approach to giant intracranial aneurysms. Operative experience with 80 cases,” J. Neurosurg., 51, 731–742 (1979).

    Article  PubMed  Google Scholar 

  19. L. Symon, “Surgical experience with giant intracranial aneurysms,” Acta Neurochir., 118, 53–58 (1992).

    Article  CAS  Google Scholar 

  20. I. R. Whittle, N. W. Dorsch, and M. Besser, “Spontaneous thrombosis in giant intracranial aneurysms,” J. Neurol. Neurosurg. Psychiat., 45, 1040–1047 (1982).

    Article  PubMed  CAS  Google Scholar 

  21. D. O. Wiebers, J. P. Whisnant, J. Huston 3rd, et al., “Unruptured intracranial aneurysms: natural history and clinical outcome, and the risks of surgical and endovascular treatment,” Lancet, 362, No. 9378, 103–110 (2003).

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. N. V. Sklifosovskii Research Institute of Emergency Care, Moscow, Russia

    V. V. Krylov, A. B. Klimov & N. A. Polunina

Authors
  1. V. V. Krylov
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. B. Klimov
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N. A. Polunina
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. A. Polunina.

Additional information

Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 111, No. 6, pp. 15–22, June, 2011.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Krylov, V.V., Klimov, A.B. & Polunina, N.A. Characteristics of the Morphology, Clinical Features, Diagnosis, and Treatment of Patients with Giant Aneurysms of the Brain Vessels. Neurosci Behav Physi 42, 980–987 (2012). https://doi.org/10.1007/s11055-012-9666-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11055-012-9666-z

Keywords

Search

Navigation