@article{oai:sapmed.repo.nii.ac.jp:00008069,
 author = {和田, 啓二 and 佐々木, 雄彦 and 中川原, 譲二 and 高坂, 研一 and 大里, 俊明 and 鷲見, 佳泰 and 片岡, 丈人 and 北条, 敦史 and 中村, 順一 and 末松, 克美},
 issue = {1},
 journal = {北海道脳神経疾患研究所医誌 = Journal of Hokkaido Brain Research Foundation},
 month = {Dec},
 note = {Acute surgery for ruptured aneurysms of the basilar artery at and around the distal bifurcation has been one of the most difficult procedures. Our series had fifteen patients that ruptured aneurysms at the basilar top or basilar-superior cerebellar artery portion. Most of all our procedures were two magnified approach, zygomatic subtemporal approach and modified Dolenc's approach, from April in 1990 to September in 1992. The clinical grades (Hunt and Kosnik grade) were II in 9 patiens, ni in 4 patients, and IV in 2 patients. Operative results (Glasgow Outcome Scale) were Good Recovery in 8 patients. Moderate Disability in 2 patients, and Severe Disability in 5 patients. No patient of the vegetative state and death has been in this series. Through these-results four risk factors toward poor outcome were chosen. These factors are large (diameter over 15mm) or giant (diameter over 25mm) sized aneurysm, aged patient, supratentorial vasospasm, and occlusion of perforating arteries during operation. Nine of fifteen patients had large or giant sized aneurysms. The large or giant sized aneurysms is one of difficult operation even in other sites. This ratio of patients is higher as compared with that of other site aneurysms. The averaged age of fifteen patients was 57 years old, but that of five patients in Severe Disability was 66.8 years old. One patient had the severe vasospasm in supratentorial vessels, followed by the Severe Disability. Two patients had the perforator infarction after the operation. Little correlation was recognized between the preoperative clinical grade and the outcome. We conclude that four risk factors, large or giant sized aneurysm, aged patient, supratentorial vasospasm and perforater occlusion, were difficult to be avoided on therapy.},
 pages = {28--33},
 title = {脳底動脈先端部近傍動脈瘤の急性期手術例における予後不良因子の検討},
 volume = {7},
 year = {1994}
}