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目的颅内巨大动脉瘤占颅内动脉瘤的5％－7％，有人报告可达到20％以上。由于部位深，周围结构复杂，以及瘤颈难以处理等因素，治疗较困难。本文报告巨大动脉瘤36例，占我院同期收治的动脉瘤6.6％（36／547）。方法血管内栓塞21例，手术夹闭或切除7例，载瘤动脉栓塞3例，保守治疗5例。结果血管内栓塞21例，其中完全栓塞3例，栓塞80％以上者（含完全栓塞）15例，余6例不足80％，死亡2例。手术夹闭或切除者7例，重残及死亡各1例。保守治疗组1例造影后破裂死亡.结论21例血管内治疗，尽管大多数病例（71．4％）仅栓塞80％，但近期效果较好。对深部位及危重的巨大动脉瘤病人，可考虑采用血管内治疗方法，但考虑血管内治疗历史短，危险性及尚未完全验证的功效，必须长期随访。
The purpose of intracranial giant aneurysms account for 5% -7% of intracranial aneurysms, it was reported up to 20% or more. Due to the deep site, the surrounding complex structure, and neck difficult to handle and other factors, the treatment is more difficult. This article reports 36 cases of giant aneurysms, accounting for 6.6% (36/547) of aneurysms admitted in our hospital over the same period. Methods 21 cases of endovascular embolization, clipping or resection in 7 cases, 3 cases of artery embolization, conservative treatment in 5 cases. Results Endovascular embolism in 21 cases, including 3 cases of complete embolization, embolization of more than 80% (including complete embolization) in 15 cases, more than 6 cases less than 80%, 2 died. There were 7 cases of occlusion or resection, 1 case of severe disability and death. One patient in the conservative treatment group died of a rupture after angiography.Conclusion In the 21 patients undergoing endovascular treatment, the effect was better in the near future, although the majority of cases (71.4%) only had an embolization of 80%. Endovascular treatment may be considered for deep sites and in critically ill patients with giant aneurysms, but long-term follow-up is warranted considering the short history of endovascular treatment, the risk and the efficacy of not yet fully validated.