Intracranial arterial aneurysms / by Walter E. Dandy.

  • Dandy, Walter Edward, 1886-1946.
Date:
1944
Catalogue details

Licence: In copyright

Credit: Intracranial arterial aneurysms / by Walter E. Dandy. Source: Wellcome Collection.

    12/178 (page 2)
    lesions and efforts directed toward their cure; and this has been forth¬ coming in the past decade. It is true that occasional presumed aneu¬ rysms of the carotid artery have had carotid ligations for over half a century, but they were hit-or-miss performances and advanced the field but little. With the recent intensive cultivation of this operative field, the actual disclosures of intracranial aneurysms have now be¬ come quite common, and these in turn have stimulated renewed in¬ terest in the diagnostic efforts. From a seemingly barren field, aneu¬ rysms in a steadily increasing number have been permanently cured. Moreover, the operative risk entailed is surprisingly small. In addi¬ tion, a very important group of hitherto unrecognized aneurysms of the intracranial carotid before it branches has been disclosed and offers one of the most favorable types for surgical treatment. The present report is based on a study of 108 patients with 133 aneurysms which have been verified by either necropsy or operation or both. Multiple aneurysms, therefore, occur in approximately 15 per cent of these cases. Since several aneurysms (as many as five) have been found in one patient, the percentage would be reduced if expressed in terms of patients, but since those cases which have been operated upon would surely have revealed additional aneurysms if pathological examinations had been possible, the actual percentage of multiple aneurysms would probably run about the same, that is, 15 per cent. Where more than one vessel has been the seat of aneurysms, the case has been entered under each branch of the circle of Willis that is involved. This has been done in order to arrive at an estimate of the relative frequency of aneurysms on each branch. This raises the num¬ ber of cases to 120; sixteen cases, therefore, have aneurysms on more than one vascular trunk, and there are 13 additional aneurysms on these trunks. The multiple aneurysms on the same trunk are confined Disj miBUTioN of Intracranial Aneurysms (Figure A) V ess els Number of Per cent of Involved Aneurysms Aneurysms A. Internal carotid in carotid canal . It 12 9. % 15. Internal carotid intracranially . 39 47 35.4 “ C. Anterior cerebral and anterior communicatin g 25 25 18.8 “ D. Middle cerebral . 22 26 19.5 “ E. Posterior communicating . — — _ F. Posterior cerebral . 2 2 1.5 “ G. Basilar and vertebral . 21 21 15.8 “ Total . . 120 133 100 “