A Clinical Analysis of Giant Intracranial Aneurysms

Intracranial aneurysms larger than 25mm in diameter are considered giant aneurysms and these comprise about 5% of all intracranial aneurysms. The authors report a series of 9 cases of giant cerebral aneurysms(>2.5cm in diameter) during a 7-year-period found among 212 cases with saccular cerebral aneurysms. Of the 9 patients, four patients were treated by direct neck clipping, one by trapping, and the other one by sac excision after direct neck clipping. This report presents an analysis of 9 cases of giant cerebral aneurysms. The results are as following : 1) In a review of our cases of giant aneurysms, approximately 4.3% were of all intracranial aneurysms. 2) Male : Female ratio was 4 : 5. 3) The greatest incidence was in the 6th decade of life. 4) The most common site was in the internal carotid artery portion. 5) Our all cases were saccular aneurysms. 6) In our cases, nonthrombosed aneurysms were more common. 7) Presenting symptom of SAH was more common. 8) There was no relationship between blood pressure and aneurysm rupture in our cases. 9) We found our all cases of ICA portion giant aneurysms presented with focal symptoms. 10) The most commonly presented focal neurologic sign was visual failure.

A Successful Occlusion of Traumatic Carotico-Cavernous Fistula with Debrun's Detachable Balloon Catheter

A case of traumatic carotico-cavernous fistula was managed by intravascular occlusion using detachable balloon catheter. The great advantage of this technique is that the cerebral blood flow can usually be preserved after the occlusion of the fistula. The fistula was obliterated by this procedure. The radiological feature, symptomatology and management were discussed with brief review of the literature.