Neuroscience and Behavioral Physiology

, Volume 42, Issue 9, pp 980–987 | Cite as

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


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.


giant aneurysms surgical treatment 


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  1. 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).Google Scholar
  2. 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).Google Scholar
  3. 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. 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).PubMedCrossRefGoogle Scholar
  5. 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.Google Scholar
  6. 6.
    C. G. Drake, “Giant intracranial aneurysms: experience with surgical treatment in 174 patients,” Clin. Neurosurg., 26, 12–95 (1979).PubMedGoogle Scholar
  7. 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).PubMedCrossRefGoogle Scholar
  8. 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).PubMedCrossRefGoogle Scholar
  9. 9.
    Y. Hosobuchi, “Direct surgical treatment of giant intracranial aneurysms,” J. Neurosurg., 51, 743–756 (1979).PubMedCrossRefGoogle Scholar
  10. 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).PubMedCrossRefGoogle Scholar
  11. 11.
    M. T. Lawton and R. F. Spetzler, “Surgical strategies for giant intracranial aneurysms,” Acta Neurochir., 72, Supplement, 141–156 (1999).Google Scholar
  12. 12.
    T. P. Morley and H. W. K. Barr, “Giant intracranial aneurysms: diagnosis, course and management,” Clin. Neurosurg., 16, 73–94 (1969).PubMedGoogle Scholar
  13. 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).CrossRefGoogle Scholar
  14. 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.Google Scholar
  15. 15.
    H. W. Pia and J. Zierski, “Giant cerebral aneurysms,” Neurosurg. Rev., 5, 117–148 (1982).PubMedCrossRefGoogle Scholar
  16. 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).PubMedGoogle Scholar
  17. 17.
    R. F. Spetzler, H. A. Riina, and G. M. Lemole, “Giant aneurysms,” Neurosurgery, 49, 902–908 (2001).PubMedGoogle Scholar
  18. 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).PubMedCrossRefGoogle Scholar
  19. 19.
    L. Symon, “Surgical experience with giant intracranial aneurysms,” Acta Neurochir., 118, 53–58 (1992).CrossRefGoogle Scholar
  20. 20.
    I. R. Whittle, N. W. Dorsch, and M. Besser, “Spontaneous thrombosis in giant intracranial aneurysms,” J. Neurol. Neurosurg. Psychiat., 45, 1040–1047 (1982).PubMedCrossRefGoogle Scholar
  21. 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).PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media New York 2012

Authors and Affiliations

  1. 1.N. V. Sklifosovskii Research Institute of Emergency CareMoscowRussia

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