破裂中大脳動脈瘤53例の検討

Analysis of 53 Ruptured Middle Cerebral Artery Aneurysms

I．序論

　microsurgical technique　の発達，instrumentの工夫，microanatomyの普及などにより，脳動脈瘤の手術成績は近年著しく向上し，なかでも中大脳動脈動脈瘤は最も成績のよい動脈瘤の1つである．しかしながら，それでも数％の死亡率を避けることができないのが現状である^{3,6,7,15-17）}．

　本研究ではCT scanで頭蓋内病変の追跡をしえた破裂中大脳動脈動脈瘤症例をretrospectiveに検討し，現在得られている治療成績をさらに向上させるため予後不良因子の分析を行った．

In spite of a recent remarkable progress in operative results of ruptured middle cerebral artery aneurysms, a mortality rate of 2-8% appears to be unavoidable. In the present study, 53 ruptured MCA aneurysms were retrospectively analyzed to determine causative factors of unfortunate outcome (fair, poor and dead).

Surgical results of 53 ruptured MCA aneurysms are shown in Table 1, where the outcome was un-fortunate in 7 cases (17%). Intracerebral hematoma was responsible for 4 cases, two of which were fatal and postoperative vasospasm for 3 cases.