Penumbral Salvage by Delayed Clip Reposition 19 Hours After Cerebral Aneurysm Clipping-Induced Ischemia Results in Neurologic Restitution-Correlation with Indocyanine Green Videoangiography and FLOW 800 Measurements.
World Neurosurg
; 138: 61-67, 2020 06.
Article
in En
| MEDLINE
| ID: mdl-32142943
ABSTRACT
BACKGROUND:
Cerebral infarction because of parent artery stenosis represents a potential complication of microsurgical aneurysm clipping. CASE DESCRIPTION We report a case of a 60-year-old woman that developed left-sided hemiparesis and aphasia 9 hours after clipping of an unruptured middle cerebral artery aneurysm with heavy calcification of the aneurysm neck. Angiographic workup revealed a marked parent artery stenosis, which occurred presumably because of thrombus generation at the reconstructed aneurysm neck. Revision surgery with relocation of the aneurysm clip was ultimately performed 19 hours after symptom onset. Although follow-up computed tomography scan showed a small cerebral infarction, the patient recovered fully from surgery.CONCLUSIONS:
This case shows that relocation of the aneurysm clip in case of vessel stenosis can lead to penumbral salvage, even when performed more than 6 hours after symptom onset.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cerebral Angiography
/
Intracranial Aneurysm
/
Brain Ischemia
/
Neurosurgical Procedures
Type of study:
Etiology_studies
Limits:
Female
/
Humans
/
Middle aged
Language:
En
Journal:
World Neurosurg
Journal subject:
NEUROCIRURGIA
Year:
2020
Type:
Article