RESUMO
Objective To discuss the microsurgical treatment of anterior communicating artery (ACoA) aneurysms at acute stage vit the supffontal approach. Methods Thirty-two patients with ruptured ACoA aneurysms,admitted to our hospital from January 2007 to October 2010 and underwent mierosurgery through supfrontal approach, were chosen in our study; their clinical manifestations,surgical methods and treatment efficacy were retrospectively analyzed. Results All 32 ACoA aneurysms in these 32 patients were clipped successfully.Forty-two aneurysm clips were used during the surgery; intraoperative aneurysm rupture occurred in 7 patients (21.88％). According to scores of Glasgow Outcome scale after 6-12 months of follow-up,26 patients (81.25％) enjoyed good results,5 (15.63％) had moderate disability and 1 (3.13％) had severe disability; no patients died,and no patients were having intracranial infection, having cerebrospinal leak or under vegetative state. Conclusion Microsurgical operation of anterior communicating aneurysms via subfronal approach was an effective and rapid method with minimal exposure and reliable neck clipping.
RESUMO
Objective To summarize the clinical effects and experiences of rapid pore cranial drilling and ventricular drainage treatment on ventricular hemorrhage to evaluate the performance of rapid pore cranial drilling. Methods The clinical data of 3571 patients with ventricular hemorrhage performed the rapid pore cranial drilling and ventricular drainage treatment from 13 hospitals of Shandong province since 1977 were retrospectively analyzed and concluded; these data were compared with those in patients received traditional Dandy's device. Results In these 3571 patients, the cure rate was 27.1%, the improvement rate was 49.1%, and the death rate was 23.8%. Rapid pore drilling needed no scalp incision, no suction, no coagulation, or no special lighting, only needed puncturing the scalp, drilling through the cranium and dura matter, implanting drainage tube and stitching it up; one can manage it in about 5 minutes at bedside; while the traditional Dandy's drilling occupied 3 people in the operating room, needed more than 20 procedures, and plus the time transporting the patient, it needed at least 60 minutes or more to finfish the procedures. Rapid pore cranial drill device is superior to Dandy's cranial drill device in operating procedures, technical performance, operation conditions, personnel and time-consuming. Conclusion Rapid pore cranial drilling greatly simplifies the operating procedures, saves precious time for the seriously ill patients, reduces the mortality and improves the effectiveness of the treatment. After 35 years of clinical practice, to those patients seriously ill needed ventricular drainage treatment to rescue their lives, rapid pore cranial drilling is superior to traditional Dandy's drill technic, and is an effective method treating such diseases.