الفهرس 
Contents
Embryology of the Cranial CirculationOnly 14 pages are availabe for public view
 |  | from | 351 |  |  |
| | | from | 351 | | |
Abstract
Introduction: Intracranial aneurysms are common, with a prevalence of 0.5% to 6% in adults, according to angiography and autopsy studies. Most intracranial aneurysms are asymptomatic and are never detected. Some are discovered incidentally in neuroimaging studies and some produce symptoms due to compression of neighboring nerves or adjacent brain tissue. Others are detected only after they have ruptured and caused subarachnoid hemorrhage, a devastating type of stroke associated with 32% to 67% case fatality and 10% to 20% long-term dependence in survivors due to brain damage. To prevent subarachnoid hemorrhage, physicians have developed methods to treat aneurysms. For ruptured aneurysms, early treatment within 24 to 72 hours has been recommended because the risk of subsequent rupture is high, with approximately 20% risk of re-rupture in the first 2 weeks after subarachnoid hemorrhage. Each additional rupture substantially increases the risk of mortality and morbidity. Treatment has also been recommended for most unruptured aneurysms, although there is uncertainty about treatment of some small aneurysms <10 mm because their risk of rupture appears low. Aim of work: This prospective study aimed to evaluate the clinical and angiographic outcomes in patients with aneurysm of anterior cerebral circulation who had been primary treated with occlusion using detachable coils as well as analyzing the advantages and disadvantages of this technique. Methods: The present study recruited 54 patients with anterior cerebral aneurysms who were subjected to aneurysmal occlusion using Guglielmi detachable coils. The participants
to through pre-interventional and post-interventional clinical and radiological assessment. Results: The present study comprised 25 males (46.3 %) and 29 females (53.7%). They had a mean age of 48.7 ± 12.2 years. In the present study, the Acom artery aneurysm was the most frequently reported site of aneurysm followed by the carotid and the MCA artery. As regards the multiplicity of the reported lesions, it was found that in 47 cases (87.03 %), the lesion was single while in the remainder 7 cases (12.97 %), the lesion was multiple. In our study aneurysmal rupture was encountered in 37 cases (59.7 %). In respect to Hunt and Hess grade of the studied aneurysms, 51.6 % of the studied aneurysms were grade 1 while 25.8 were grade 2, 19.4% were grade 4 and 3.2 % were grade 5. The shape of aneurysm was irregular in a vast majority of cases (96.8%) and only 3.2 % had regular shape. As regards the complications rate in the present study, we found that 5 cases out of 62 had significant complications (8.0%). Also, aneurysmal rupture was not related to the site of aneurysm. In addition, no statistically significant differences were found between males and females regarding the frequency of aneurysmal rupture. Conclusions: The primary treatment of intracranial aneurysms (ruptured and unruptured) is the endovascular treatment. The variety of clinical and anatomical situations encountered led to the development of concepts, techniques or technologies. There is an evolution of the experiences of neuroendovascular teams. The coiling (coiling alone or with the remodeling or stenting) remains the standard treatment of intracranial aneurysms. Stenting and the diversion of flows are two important ways in development.