Proceedings: Direct surgery of anterior communicating aneurysms and its effect on intellect and personality.
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Biomedical subjects
Publications and source records attributed to R P Sengupta.
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The authors describe a series of 32 patients with ruptured aneurysms of the anterior communicating artery who were admitted during a 3-year period. In 28, the aneurysms were treated by direct surgery with no deaths; 26 of these patients were studied psychometrically from 4 to 33 months after operation. There was no evidence of postoperative intellectual impairment; however, there were personality changes associated with loss of interest, initiative, and energy. Analysis of the different factors involved suggests to the authors that the outcome of surgery depends mainly on preoperative clinical condition which, in turn, reflects the severity of the hemorrhage.
Carotid bifurcation aneurysms have, as a group, certain characteristics. They account for about 7% of all intracranial aneurysms. They appear to be mostly leftsided and there does not seem to be any particular sex predominance. When associated with other aneurysms, the carotid bifurcation aneurysm was the symptomatic lesion. Demonstration of small aneurysms may be difficult and accurate definition of the neck may not be possible at angiography. They appear to associate themselves with one or the other division of the internal carotid artery. With careful exposure and appropriate positioning of the head it is possible to occlude these aneurysms with a clip, but we feel that the inexperienced surgeon should not tackle these cases. Carotid artery ligation may not prevent rebleeding in this group of aneurysms.
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A case of tabetic neuroarthropathy of the lumbar spine causing cauda equina compression with paraplegia and retention of urine is described. The literature is reviewed and the role of surgery in such cases is discussed.
Three cases of extradural haematoma during ventricular drainage are reported and the relevant literature has been reviewed. Aetiology, diagnosis, and management are discussed. Defective blood clotting is mentioned as a possible precipitating factor.
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