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The surgical treatment of anterior communicating artery aneurysms.

Forty consecutive cases of ruptured anterior communicating artery aneurysms are studied. Thirty of these were operated on. In 29 the aim of surgery was to clip the neck of the aneurysm. Of these patients, 73% returned to normal life, 9% were left with a permanent mild disability, 8% with a moderate disability and 10% died in the postoperative period. Angiographic spasm was not in itself a contraindication to surgery, the clinical state of the patient being the most useful index. In selected cases definitive treatment to occlude the neck of the aneurysm to prevent recurrent hemorrhage can be undertaken with acceptable results, giving a better outlook than the natural history of an untreated anterior communicating artery aneurysm.