Journal of neurosurgery
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The microsurgical anatomy of the middle cerebral artery (MCA) was defined in 50 cerebral hemispheres. The MCA was divided into four segments: the M1 (sphenoidal) segment coursed posterior and parallel to the sphenoid ridge; the M2 (insular) segment lay on the insula; the M3 (opercular) segment coursed over the frontoparietal and temporal opercula; and the M4 (cortical) segment spread over the cortical surface. The Sylvian fissure was divided into a sphenoidal and an operculoinsular compartment. ⋯ The smallest cortical arteries arose at the anterior end and the largest one at the posterior end of the Sylvian fissure. The largest cortical arteries supplied the temporo-occipital and angular areas. The relationship of each of the cortical arteries to a number of external landmarks was reviewed in detail.
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Journal of neurosurgery · Feb 1981
Clinical TrialEarly management of aneurysmal subarachnoid hemorrhage. A report of the Cooperative Aneurysm Study.
The overall results are presented of early medical management and delayed operation among 249 patients studied during the period 1974 to 1977, treated within 3 days of subarachnoid hemorrhage (SAH) and evaluated 90 days after aneurysm rupture. The results included 36.2% mortality, 17.9% survival with serious neurological sequelae, and 46% with a favorable outcome. ⋯ These figures represent the results despite effective reduction in early rebleeding by antifibrinolytic therapy and successful surgery in those patients reaching operation. Further therapeutic advances are needed for patients hospitalized within a few days after SAH.