ABSTRACT
A giant fusiform aneurysm of the middle cerebral artery is a disease that causes many difficulties for endovascular intervention as well as surgery. No 1 solution is optimal for all cases, however for post-bifurcation aneurysms, trapping the aneurysms with a reanastomosis reimplantation, an in situ side to side bypass is feasible and has good results. We reported a 28-year-old male patient, admitted to the hospital because of severe headache, Glasgow Coma Scale 13 points, left hemiplegia, was diagnosed with subarachnoid hemorrhage due to rupture of a giant fusiform aneurysm of the middle cerebral artery in the M2 segment, Hunt and Hess grade 4. The patient underwent microsurgery with clipping aneurysm combined with a low-flow technique connecting the superficial temporal artery to the middle cerebral artery. Our findings suggest that surgery to connect the superficial temporal artery to the M2 segment and at the same time obstructing the parent artery occlusion of selected giant MCA aneurysm is an option to consider.
ABSTRACT
We present a 60-year-old female diagnosed with a giant trigeminal tumor (5.2*6.4*8.2 cm) situated in the middle cranial fossa and nasopharyngeal area. The patient was operated on by endoscopic endonasal transmaxillary, transpterygoid and infratemporal approaches. Postoperatively she was stable, with no neurologic complication and no cerebrospinal fluid leakage. We review the literature on extremely large trigeminal schwannomas.
Subject(s)
Cranial Nerve Neoplasms , Neurilemmoma , Cranial Nerve Neoplasms/diagnostic imaging , Cranial Nerve Neoplasms/surgery , Endoscopy , Female , Humans , Middle Aged , Nasopharynx , Neurilemmoma/diagnostic imaging , Neurilemmoma/surgery , NoseABSTRACT
BACKGROUND: The anterior inferior cerebellar artery (AICA) aneurysms are rare lesions whose treatment can be challenging. There are only a few previous reports of surgical treatment for such lesions. OBJECTIVES: We present a case of a basilar-AICA aneurysm undergoing surgery with the combined transpetrosal approach. CASE DESCRIPTION: A 58-year-old female patient presented clinical signs including headache, diplopia, and right hemiparesis. The radiological imaging showed a basilar-AICA aneurysm measuring 25 × 19 mm. The patient was operated via left combined transpetrosal approach. The outcome was graded mRankin 1. Follow-up computerized tomographic angiography showed no aneurysmal residual and total preservation of basilar artery. DISCUSSIONS: Surgical indication's purposes were aneurysmal elimination and reduction of mass effect. Combined transpetrosal approach: proximal segment control and enough space for clipping manipulation. Clipping techniques: Temporary clip for aneurysmal collapsing, "orienting clip". CONCLUSION: Giant basilar-AICA aneurysm is very rare lesion. Combined transpetrosal approach is appropriate for surgical clipping. Good surgical outcome is achieved with complete elimination of aneurysm.
ABSTRACT
This association had been reported for long time with a frequency of 2.7-23% of cases of intracerebral arteriovenous connection. This association increases the risk of cerebral meningo hemorrhage. 3 cases of cerebral meningo hemorrhage associated with intracerebral arteriovenous connective malformation were studied retrospectively and treated at Viet Duc Hospital from January 1999 to January 2004. The presence of aneurysm in cerebral arteriovenous connection was an important predictive factor for the hemorrhage possibility, leading to cerebral hemorrhage
Subject(s)
Aneurysm , Arteriovenous Malformations , Intracranial Arteriovenous Malformations , Congenital AbnormalitiesABSTRACT
3 cases of intracranial aneurismal residue following clipping at Viet Duc Hospital were studied. The causes of this condition were anatomical and technical. It is necessary to identified prior surgery the cause of hemorrhage, to limit the disruption of aneurism, to expose entirely the neck of aneurism before the setting of clip and to explore throughly the place of clip- Anterigraphy or systematic Xray control should be made for checking the results
