The effect of neck clipping on giant intracranial aneurysms

A giant intracranial aneurysm usually reveals such clinical symptoms as a space-occupying lesion. Therefore, it seems that the best treatment for a giant intracranial aneurysm is neck clipping with aneurysmectomy. Most giant intracranial aneurysms, however, are difficult to treat with aneurysmectomy. Therefore, neck clipping without aneurysmectomy may be the treatment of choice for a giant aneurysm arising from the basilar artery because of its anatomical location. Neck clipping alone, however, cannot be expected to remove its mass effect immediately, so the effect of the neck clipping on the giant intracranial aneurysm must be discussed on the basis of a long follow-up study. The present authors experienced two patients with giant intracranial aneurysms which had been treated with neck clipping only. The sequential changes in the giant intracranial aneurysms after neck clipping were studied on the CT scan. 1. The giant intracranial aneurysm had diminished in its CT number and in size after neck clipping. 2. The peripheral part of the aneurysm treated with neck clipping was enhanced with a post-contrast scan, which seemed to be affected by the meningeal reaction to the thrombosed aneurysm. 3. From a long-prognostic point of view, neck clipping, even though without aneurysmectomy, may have a good effect on a giant intracranial aneurysm. (author)