Aneurysms of the distal anterior cerebral artery (DACA) are rare and their
surgical treatments present some unique difficulties from a technical stand
point. In this report, we presented our experiences of cases with DACA aneu
rysms, and analyzed the clinical features and prognostic factors affecting
the final outcomes. Among 770 cases of intracranial aneurysms operated from
1990 to 1998, 19 cases of DACA aneurysms (2.5%) were studied retrospective
ly. The characteristic findings were female preponderance (M:F=1:2.8), comm
on multiple aneurysms (57.9%), and frequent intracerebral hemorrhage (ICH)
on initial brain CT scan (42.1%). All patients were operated via interhemis
pheric approach. Intraoperative aneurysmal rupture was developed only in 3
cases (15.8%), and had no relationship with the final outcome. Fifteen out
of 19 patients (78.9%) shaved favorable outcome with a mortality rate of 5.
3%. The follow-up data suggest that the initial ICH on brain CT scan porten
d a poor prognosis.