Aneurismas da artéria comunicante anterior: considerações sobre 14 casos operados

Sampaio, Pedro

doi:10.1590/S0004-282X1970000400007

Resumos

Após algumas considerações sobre a freqüência e o quadro clínico dos aneurismas da artéria comunicante anterior, é relatada a experiência do autor, constante de 14 casos operados: nove pacientes se recuperaram totalmente, um sobreviveu com incapacidade parcial e quatro faleceram. O tratamento cirúrgico, apesar de todos os percalços, é ainda a melhor terapêutica, quando possível. Para a indicação cirúrgica quanto às condições do paciente, foi seguida a classificação de Boterell e col. modificada por Hunt e Hess.

After some considerations about the frequency and clinical features of the anterior communicating artery aneurysms the author's experience on 14 cases operated is reported: nine patients are alive and well, one is disabled and 4 are dead. The author think, by now, that the best treatment is to clip the neck of the aneurysm. The classification of Botterell et al. modified by Hunt and Hess was followed to indicate surgical treatment.

Aneurismas da artéria comunicante anterior. Considerações sobre 14 casos operados

Anterior communicating artery aneurysms. Comments based on 14 operated cases

Pedro Sampaio

Professor de Neurocirurgia no Instituto de Neurologia da Universidade Federal do Rio de Janeiro

RESUMO

Após algumas considerações sobre a freqüência e o quadro clínico dos aneurismas da artéria comunicante anterior, é relatada a experiência do autor, constante de 14 casos operados: nove pacientes se recuperaram totalmente, um sobreviveu com incapacidade parcial e quatro faleceram. O tratamento cirúrgico, apesar de todos os percalços, é ainda a melhor terapêutica, quando possível. Para a indicação cirúrgica quanto às condições do paciente, foi seguida a classificação de Boterell e col. modificada por Hunt e Hess.

SUMMARY

After some considerations about the frequency and clinical features of the anterior communicating artery aneurysms the author's experience on 14 cases operated is reported: nine patients are alive and well, one is disabled and 4 are dead. The author think, by now, that the best treatment is to clip the neck of the aneurysm. The classification of Botterell et al. modified by Hunt and Hess was followed to indicate surgical treatment.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Instituto de Neurologia Avenida Venceslau Braz, 95, Botafogo Rio de Janeiro, GB Brasil

1. AHMED, R. H. & SEDRIMIS, C. B. Ruptured anterior communicating aneurysm. A comparasion of medical and specific surgical treatment J. Neurosurg. 26:213, 1967.
2. ALLČGRE, G. & VIGOUROUX Traitement Chirurgical des Aneurysmes Intracraniens du Systčme Carotidien. Masson et Cie., Paris, 1957, pg. 30.
3. ANDREWS, Y.; NATHON, P. W. & SPANOS N. C. Disturbances of micturition and defeccation due to aneurysms of anterior communicating or anterior cerebral arteries. J. Neurosurg. 24:1-10, 1966.
4. BOTTERELL, E. H.; LOUGHEED, W. M.; SCOTT J. W. & VANDEWATER, S. L. Hypothermia and interruption of carotid or carotid and vertebral circulation in the surgical management of intracranial aneurysms. J. Neurosurg. 13:1-42, 1956.
5. DANDY, W. E. Intracranial Arterial Aneurysms. Itharca, N. Y., 1944.
6. FRANKEL, K. Relation of migraine to cerebral aneurysm. Arch. Neurol, a. Psychiat. (Chicago) 63: 195, 1950.
7. FRENCH, L. A.; ZARLING, M. E. & SCHLTZ, E. A. Management of aneurysms of the anterior communicating artery. J. Neurosurg. 21:870, 1962.
8. HUNT, W. E. & HESS, R. M. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J. Neurosurg. 28:14, 1968.
9. KRAYENBOHL, H. L'Aneurysme de l'Artčre Communicante Antérieure. Masson et Cie., Paris, 1959, pg. 50.
10. LOCKSLEY, H. B.; SACHS, A. L. & KNOWLER, L. Report on the Cooperative Study of Intracranial Aneurysms and Subarachnoid Hemorrhage. J. Neurosurg. Section II; 24:922, 1966.
11. LOKSLEY, H. B. Report on the Cooperative Study of Intracranial Aneurysms and Subarachnoid Hemmorrhage. J. Neurosurg, Part. I; 25:219, 1966.
12. LOGUE, V. Surgery in spontaneous subaracnoid hemorrage. Operative treatment of aneurysms on the anterior cerebral and anterior communicating artery. Brit. Med. J. 1:473. 1956.
13. MCKISSOCK, W.; RICHARDSON, A. & WALSH, L. Anterior communicating aneurysms. A trial of conservative and surgical treatment. Lancet 1:879, 1965.
14. POOL, J. L. Timing and techniques in the intracranial surgery of ruptured aneurysms of the anterior communicating artery. J. Neurosurg. 21:378, 1962.
15. TÖNNIS, W. Erfolgreiche Behandlung eines Aneurysmas der Art. Comunicans ant. cerebri. Zentralbl. f. Neurochir. 11:39, 1936.
16. TOOLE, J. F. & PATL, A. N. Cerebrosvascular Disorders. Mc Graw Hill Book Company, New York, 1967. pg. 223.
17. WHITE, J. C. & BALLANTINE, H. T. Intrasellar aneurysms simulating hypophyseal tumors. J. Neurosurg. 18:34, 1961.

Datas de Publicação

Publicação nesta coleção
22 Abr 2013
Data do Fascículo
Dez 1970

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. AHMED, R. H. & SEDRIMIS, C. B. Ruptured anterior communicating aneurysm. A comparasion of medical and specific surgical treatment J. Neurosurg. 26:213, 1967.

[2] 2. ALLČGRE, G. & VIGOUROUX Traitement Chirurgical des Aneurysmes Intracraniens du Systčme Carotidien. Masson et Cie., Paris, 1957, pg. 30.

[3] 3. ANDREWS, Y.; NATHON, P. W. & SPANOS N. C. Disturbances of micturition and defeccation due to aneurysms of anterior communicating or anterior cerebral arteries. J. Neurosurg. 24:1-10, 1966.

[4] 4. BOTTERELL, E. H.; LOUGHEED, W. M.; SCOTT J. W. & VANDEWATER, S. L. Hypothermia and interruption of carotid or carotid and vertebral circulation in the surgical management of intracranial aneurysms. J. Neurosurg. 13:1-42, 1956.

[5] 5. DANDY, W. E. Intracranial Arterial Aneurysms. Itharca, N. Y., 1944.

[6] 6. FRANKEL, K. Relation of migraine to cerebral aneurysm. Arch. Neurol, a. Psychiat. (Chicago) 63: 195, 1950.

[7] 7. FRENCH, L. A.; ZARLING, M. E. & SCHLTZ, E. A. Management of aneurysms of the anterior communicating artery. J. Neurosurg. 21:870, 1962.

[8] 8. HUNT, W. E. & HESS, R. M. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J. Neurosurg. 28:14, 1968.

[9] 9. KRAYENBOHL, H. L'Aneurysme de l'Artčre Communicante Antérieure. Masson et Cie., Paris, 1959, pg. 50.

[10] 10. LOCKSLEY, H. B.; SACHS, A. L. & KNOWLER, L. Report on the Cooperative Study of Intracranial Aneurysms and Subarachnoid Hemorrhage. J. Neurosurg. Section II; 24:922, 1966.

[11] 11. LOKSLEY, H. B. Report on the Cooperative Study of Intracranial Aneurysms and Subarachnoid Hemmorrhage. J. Neurosurg, Part. I; 25:219, 1966.

[12] 12. LOGUE, V. Surgery in spontaneous subaracnoid hemorrage. Operative treatment of aneurysms on the anterior cerebral and anterior communicating artery. Brit. Med. J. 1:473. 1956.

[13] 13. MCKISSOCK, W.; RICHARDSON, A. & WALSH, L. Anterior communicating aneurysms. A trial of conservative and surgical treatment. Lancet 1:879, 1965.

[14] 14. POOL, J. L. Timing and techniques in the intracranial surgery of ruptured aneurysms of the anterior communicating artery. J. Neurosurg. 21:378, 1962.

[15] 15. TÖNNIS, W. Erfolgreiche Behandlung eines Aneurysmas der Art. Comunicans ant. cerebri. Zentralbl. f. Neurochir. 11:39, 1936.

[16] 16. TOOLE, J. F. & PATL, A. N. Cerebrosvascular Disorders. Mc Graw Hill Book Company, New York, 1967. pg. 223.

[17] 17. WHITE, J. C. & BALLANTINE, H. T. Intrasellar aneurysms simulating hypophyseal tumors. J. Neurosurg. 18:34, 1961.

Brasil

Brasil

Aneurismas da artéria comunicante anterior: considerações sobre 14 casos operados

Anterior communicating artery aneurysms: comments based on 14 operated cases

Resumos

Datas de Publicação