PMID: 16524239Mar 10, 2006Paper

Cerebrovascular surgery. Dilemmas

Anales de la Real Academia Nacional de Medicina
Máximo Poza Poza

Abstract

1ST DILEMMA: Many cerebral aneurysms are asymptomatic. Five per cent of adults have a cerebral aneurysm in necropsies. Only one case in ten thousand bleed. Is it reasonable to treat unruptured ones? SECOND: Symptomatic aneurysms. Surgery or embolization? ISAT report. Similar morbimortality. Depends on personal experience. Les aggresiveness with endovascular treatment. Many remnants after embolization. Arteriovenous malformations. Radical removal. Risk in great volume malformations or those located in eloquent or deep places. Many incomplete replections. Contributory to surgery. Limit of size. Risk of rebleeding for long-time after treatment. Associated treatment. Decisión depends on each patient.

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