[Morphologic analysis of the coexisting anomalies of the arteries of the cerebral base and aneurysms: clinical study].

During operations of the aneurysms showing anatomical details is the means that leads to the aim, and it is not only a purpose in itself. Data on details that the surgeons come across during their work and which sometimes represent difficulties during interpretations of angiographic findings and planning operations, as well as the intraoperative orientations and identifications of the elements . Frequency of occurrence of such anatomical details and anomalies may be completely different from the one that autopsy series show. Knowledge of this makes the work of surgeons easier and gives a necessary feeling of confidence during operations. Thus, we decided to conduct a clinical, morphological study based on angiographic and surgical analyses of the explored segments of the Wilson circle. The study included 344 patients from the Institute for Neurosurgery, during the period of 2 years; the patients had complete angiographic diagnosing and operative exploration. Our findings confirm differences in localization of aneurysms according to sex. Aneurysms on the front communicant complex are to a great extent associated with anomalies of the front part of the Wilson circle.

[Natural course of the arteriovenous malformations of the brain].

Arteriovenous cerebral malformations represent congenital malformations. Considering the anatomical characteristics of the cerebral angiomas and their localization, in a great number of cases they demand a combined therapeutic approach--surgery, embolization and radiotherapy. Besides the constant progress of technology, 5% of all cerebral angiomas can not be completely excluded from the circulation. Therefore, the need to understand their natural course became a necessity. Our results point to the fact that they are vascular malformations of a considerably more benign clinical course than the aneurysms. Our clinical model points to an annual risk of hemorrhage which is 3.3% with total mortality of 5.3%, especially if the size of the angioma is 2.5-5 cm, localized in the motor zone of the brain, with combined type of vein drainage and arterial supply from the vertebrobasilary confluence. Epilepsy caused by the cerebral angioma is in 26.7% refractory to medicamentous therapy and in 25% (every 4th patient) will have hemorrhage with an annual risk of 0.14%.