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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(02): 422-426
DOI: 10.4103/ajns.AJNS_161_18
Original Article

Small aneurysms should be clipped?

Gustavo Noleto
Department of Neurosurgery, University of São Paulo Medical School, São Paulo
,
Nícollas Rabelo
Department of Neurosurgery, University of São Paulo Medical School, São Paulo
,
Leonardo Abaurre
Department of Neurosurgery, University of São Paulo Medical School, São Paulo
,
Hugo Neto
Department of Neurosurgery, University of São Paulo Medical School, São Paulo
,
Mario Siqueira
Department of Neurosurgery, University of São Paulo Medical School, São Paulo
,
Manoel Teixeira
1   Department of Neurosurgery, São Paulo University, São Paulo
,
Eberval Figueiredo
Department of Neurosurgery, University of São Paulo Medical School, São Paulo
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Background: Cerebral aneurysm prevalence may vary from 0.4% to 10%. The decision to treat or not incidental aneurysms remains controversial, especially when the lesions are small (<5 mm). Many recent publications are demonstrating that these lesions often bleed. Methods: We reviewed admitted patients with angiographic studies submitted to intracranial aneurysm surgical treatment from April 2012 to July 2013 in the Neurosurgery Department of São Paulo Medical School University (15 months), to define the rate and risk of bleeding. In addition, we proceeded literature review with collected 357 papers (past 5 years) which were selected 50 that were focused on our research. Clinical patients' status at the time of discharge was evaluated with the modified Rankin scale. Results: A series of 118 cases of surgically clipped aneurysms was analyzed: 73.7% woman; Ruptured (61 cases, 51%); middle cerebral artery (51 cases, 43%) was the more common aneurysm. Small size (<5 mm) was 25 cases (21%); that 2 died (16%), 3 (25%) with severe disability,restricted to bed and dependent on nursing care; blood pressure was the main risk factors (56%); and an aneurysm <2 mm (100%) was ruptured. Conclusion: The number of small aneurysms in our series was significant (25 cases, 21%), and its rate of bleeding was high (25 cases, 48%), resulting in death and disability in a significant number of cases. Our tendency is for surgical treatment when it is associated with risk factors.

Key-words:

Aneurysm clipped - cerebral hemorrhage - intracranial aneurysm - small cerebral aneurysm - subarachnoid hemorrhage

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Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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