ENDOSCOPIC-GUIDED CLIPPING OF CEREBRAL ANEURYSMS

An endoscopic probe has been used intraoperatively to facilitate the o bliteration of cerebral aneurysms. This method has been used in 24 pat ients with 30 arterial aneurysms. There were 13 males and 11 females. They ranged in age from 22 to 73 years (mean age 48 years). The mean t ime of surgery was 7.3 days after subarachnoid haemorrhage (ranging fr om 2 to 24 days). In three cases there was intraoperative rupture of t he aneurysm and with one patient the operation had to be abandoned bec ause of severe brain oedema. The follow-up ranged from 12 to 48 weeks (average 31.8 weeks). The overall outcome was good in 14 cases (58.3%) , eight patients (33.3%) showed moderate disability, severe disability occurred in one patient (4%) and one patient (4%) died. In all cases when the endocsope was used, there was a striking improvement in the v isualisation of the anatomy of the aneurysm and surrounding structures . Furthermore, the position of the clip and the state of the vessels l eading to and from the aneurysm could be easily examined.