Craniotomy for the treatment of high-grade ruptured anterior communicating artery aneurysms
Yi Jing
Chen Hua
Que Siwei
Abstract：Objective To explore the craniotomy diagnosis and treatment plan for high-grade ruptured anterior communicating artery aneurysms(ACoAA).Methods Clinical data of 23 patients with high-grade ruptured ACoAA were analyzed retrospectively.Preoperative examinations included head computed tomography(CT)and CT angiography(CTA)or digital subtraction angiography(DSA).Among them,17 patients were classified as Hunt-Hess grade Ⅳ and 6 as grade V;3 patients were classified as modified Fisher grade 2,13 as grade 3,and 7 as grade 4.All 23 patients underwent craniotomy under general anesthesia.Results Aneurysms in 22 ACoAA patients were completely clipped,while 1 aneurysm was difficult to clip and was isolated instead.Decompressive craniectomy was performed in 16 patients,and external ventricular drainage was performed in 20 patients.Five patients died postoperatively,and 4 patients refused further treatment and were discharged by signature.Ventriculoperitoneal shunting was performed in 7 patients,while the remaining patients showed varying degrees of improvement in their preoperative clinical symptoms.The Glasgow outcome scale(GOS)score 4-5 were considered as good prognosis.At discharge,there were 2 patients with GOS score of 5,5 with 4 points,2 with 3 and 5 with 2.Three months after operation,3 patients achieved a GOS score of 5 points,4 achieved 4,4 did 3 and 3 did 2.Conclusions For high-grade ruptured ACoAA,craniotomy should be performed actively,and some patients can achieve a good prognosis.
Keywords：intracranial aneurysmruptureanterior communicating arteryneurosurgical procedures
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 140-143 )