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Abstract - Original Article
| J Cerebrovasc Endovasc Neurosurg. 2024 26(1): 37-45 ¨Ï The Journal of Cerebrovascular and Endovascular Neurosurgery |
 
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| Microsurgical treatment of distal middle cerebral artery aneurysm: A single-center review |
| Taehoon Jang1, Sung-Tae Kim1, Jin Lee1, Won-Hee Lee1, Keun-Soo Lee1, Se-Young Pyo1, Junghae Ko2, Hangwoo Lee3, Yeong Gyun Jeong1 |
| 1Department of Neurosurgery, Busan Paik Hospital, Inje University, School of Medicine, Busan, Korea 2Department of Endocrinology, Haundae Paik Hospital, Inje University, School of Medicine, Busan, Korea 3Department of Neurosurgery, Busan St. Mary¡¯s Hospital, Busan, Korea |
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| Objective: To review the characteristics of distal middle cerebral artery (MCA) aneurysm treated by microsurgery, the detailed surgical options, and the clinical result.
Methods: We retrospectively reviewed cerebral aneurysm in the M2 and M3 segments of the MCA surgically treated between January 2015 and December 2022. The demographic data, aneurysm-related findings, type of surgical approach, surgical technique, and clinical outcomes of the enrolled patients were analyzed.
Results: Sixteen distal MCA aneurysms were treated with microneurosurgery (incidence, 1.0%; female, 12; mean age, 58.1 years; ruptured, three). Twelve aneurysms were in the M2 segment (insular segment), two aneurysms at the M2R11;M3 junction, and two aneurysms in the M3 segment (opercular segment). Twelve aneurysms were saccular (average size, 4.9 mm; multiplicity, 50%; average aneurysms, 3.0; partially thrombosed, 1; sidewall aneurysm, 2). Three aneurysms were fusiform, of which two were ruptured. Of the ruptured aneurysms, one was a ruptured dissecting aneurysm. The trans-sylvian and trans-sulcal approaches were used in fourteen and two patients, respectively. Neck clipping, wrap clipping, and surgical trapping were performed in twelve, one, and one patient, respectively. Proximal occlusion was performed in one patient. Bypass technique was required in two patients (neck clipping and proximal occlusion). The modified Rankin Score was 6 in the two patients with ruptured aneurysms. The remaining patients did not show further neurological deterioration after microneurosurgery.
Conclusions: Distal MCA aneurysms had a high incidence of being diagnosed with multiple other aneurysms and were relatively non-saccular. |
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| Key words : Distal, Intracranial aneurysm, Microsurgery, Middle cerebral artery |
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