The management of aneurysms of the circle of Willis is a trying problem. The practitioner faced with the care of a patient with such a lesion, whether it is ruptured or unruptured, finds little peace of mind in the decision to follow a conservative program in the hope that the natural reparative processes will somehow produce a cure. The knowledge that this happens only infrequently makes the responsibility of that decision even more burdensome.
The diagnosis of aneurysm of the circle of Willis is being made more frequently as there is greater recognition that most subarachnoid hemorrhages are caused by rupture of such a lesion. Even though he may eventually discharge from the hospital about one-half of his patients with bleeding aneurysms, the practitioner finds little comfort in the thought that such patients, who are frequently young, are in constant jeopardy. At any moment, without warning, bleeding may start again.
Bassett RC, Gass HH. LIGATION OF INTERNAL CAROTID ARTERY FOR ANEURYSMAL LESIONS OF CIRCLE OF WILLIS. JAMA. 1951;147(9):842–846. doi:10.1001/jama.1951.03670260044013
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