Ruptured aneurysms of the middle cerebral artery

✓ Eighty-four consecutive patients with ruptured aneurysms of the middle cerebral artery were operated on between 1947 and 1969 at the Neurosurgical Unit, Dunedin Hospital, Dunedin, New Zealand. The lesions were commoner in women. Poor clinical condition, hypertension, retinal hemorrhage, age over 50 years, intracerebral hematoma, and very early operation each affected the surgical mortality adversely. The over-all mortality was 36.6%, and better patient selection reduced this to 7.8%. Clipping the aneurysm proved to be a better method of treatment than investment with muscle and gauze. Two-thirds of the surviving patients returned to full or partial working capacity.