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뇌동맥류 및 뇌동정맥기형에 관한 임상적 연구 : Clinical Study on the Intracranial Aneurysms and Arteriovenous

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dc.contributor.author한대희-
dc.contributor.author심보성-
dc.date.accessioned2009-09-14T14:51:24Z-
dc.date.available2009-09-14T14:51:24Z-
dc.date.issued1972-06-
dc.identifier.citationSeoul J Med, Vol.13 No.2, pp. 143-163-
dc.identifier.issn0582-6802-
dc.identifier.urihttps://hdl.handle.net/10371/9267-
dc.description.abstractIt is well known that approximately 35-50 per
cent of all patients with a spontaneous subarachnoid
hemorrhage die in the first attack and about 40 per
cent of the survivors expire due to recurrent attacks
some time within the following five years. These
hemorrhages occur principally from ruptured aneurysms
located on the great vessels at the base of
the brain, and some from ruptured arteriovenous
malformations.
The purpose of this report is to present the
results of clinical observations and treatments in 62
patients with intracranial aneurysms and 25 patients
with intracranial arteriovenous malformations,
durng period from September, 1957 to August, 1971
at the Department of Neurosurgery, Seoul National
University, Seoul, Korea.
There were 119 cases of spontaneous subarachnoid
hemorrhage among 312 patients of cerebrovascular
diseases, of which 58 cases (48%) were due to
ruptured intracranial aneurysms and 14 cases (12%)
were due to arteriovenous malformations. Unruptu•
red aneurysms were found in 4 patients (6.5% of all
aneurysm cases) and unruptured arteriovenous malformations
in 11 patients (44% of all A. V. M. cases).
There were 36 males (58%) and 26 females (42%)
among aneurysm cases, and 19 males (76%) and 6
females (24%) among arteriovenous malformation
cases. The highest age incidence was found in
fourth and fifth decades in aneurysriJ.ai groups, and
in third and fourth decades in arteriovenous malformation
group.
The site of a single aneurysm was on the internal
carotid artery in 46. 2 per cent; anterior cerebral
artery complex in 25.4 per cent; middle cerebral
artery in 22.4 per cent and vertebrobasilar system
in 6. 0 per cent. Multiple aneurysms were found in
8 per cent and all were associated with the internal
carotid artery aneurysms. All unruptured aneurysms
were located on the internal carotid artery, three
of them were in the intracavernous portion and one
at the bifurcation of the posterior communicating
artery.
Nineteen cases (76%) of 25 arteriovenous malformations
were angiomatous malformations, 4 cases
(16%) were carotid•cavernous fistulas and 2 cases
(8%) were combined intracranial-extracranial arte•
riovenous malformations. The parietal area was the
most prevalent site of supratentorial angiomatous
malformations, and infratentorial arteriovenous
malformations were only three cases (12%) .
Main feeding arteries to these arteriovenous
malformations were the middle cerebral artery in 40
per cent, anterior cerebral artery 24 per cent and
internal carotid artery in 20 per cent, while the
main draining veins were the sagittal sinus in 36
per cent, internal cerebral veins in 36 per cent and
other cortical veins in 32 per cent.
The size of aneurysms varied as follows: 3-5 mm
in 43.5 per cent, 6-10 mm in 47.1 per cent, and
over 10 mm in 9.4 per cent. Angiographically,
generalized arterial spasm was found in 38. 7 per
cent of 58 ruptured aneurysm cases, localized arterial
spasm in 25. 8 per cent, spasm only in parent
artery in 19.4 per cent. UsuallY cerebral angiography
was performed when the patient's condition
was good but when intracerebral hematoma or
subdural hematoma was suspected in ruptured
aneurysms, angiography was done immediately. In
78 per cent of aneurysm cases, angiography was
performed within 3 weeks. Bilateral or triple angi
ography was done in 43. 6 per cent of intracranial
aneurysms and unilateral was done in 56.4 per cent
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dc.language.isoko-
dc.publisher서울대학교 의과대학-
dc.title뇌동맥류 및 뇌동정맥기형에 관한 임상적 연구-
dc.title.alternativeClinical Study on the Intracranial Aneurysms and Arteriovenous-
dc.typeSNU Journal-
dc.contributor.AlternativeAuthorHan, Dae Hee-
dc.contributor.AlternativeAuthorSim, Bo Sung-
dc.citation.journaltitle서울 의대 잡지-
dc.citation.journaltitle서울 의대 학술지-
dc.citation.journaltitleSeoul Journal of Medicine-
dc.citation.endpage163-
dc.citation.number2-
dc.citation.pages143-163-
dc.citation.startpage143-
dc.citation.volume13-
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