Specific Treatment of Intracranial Aneurysms

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Abstract
Alternative methods of treating intracranial aneurysms are discussed, based on personal experience with 143 surgically treated patients. It is noted that "intracranial trapping", or ligation of an internal carotid artery, gives a good result when this indirect approach is feasible and is attended by a low mortality. The direct approach (excision of the aneurysm) has a low mortality if the cases are selected carefully. Evacuation of a portion of organized clot from a large intracranial aneurysm appears to have no particular merit either in relieving symptoms or in prolonging life. Exposure of a large intracranial aneurysm directly attached to the circle of Willis should be discouraged in all cases. The fatalities occurred in patients who were not carefully chosen, prior to the routine use of arteriography and in patients in whom the site of the aneurysm precluded surgery.

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