For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
15
views
8
references
 Top references
cited by
0
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      489
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Suction Decompression during Anterior Clinoidectomy for Direct Clipping of Paraclinoid Aneurysm Involving the Anterior Clinoid Process

      case-report

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Surgical clipping of paraclinoid aneurysms involving the anterior clinoid process (ACP) can present great challenges because strong adhesion may hinder dissection of the surrounding anatomical structures from the aneurysm dome. On the other hand, retrograde suction decompression (RSD) through direct puncture of the common carotid artery is a useful adjunct technique for clipping of these aneurysms. The present case illustrates that direct clipping of paraclinoid aneurysms involving the ACP can be achieved safely and less invasively using RSD during anterior clinoidectomy. Postoperatively, her clinical course was uneventful. RSD is a useful technique during anterior clinoidectomy in direct clipping of paraclinoid aneurysms involving the ACP.

          Related collections

          Most cited references8

          • Record: found
          • Abstract: found
          • Article: not found

          Aneurysms of the ophthalmic segment. A clinical and anatomical analysis.

          Emily A. Day (1990)
          The clinical, radiographic, and anatomical features in 80 patients with ophthalmic segment aneurysms were reviewed, and were categorized according to a presumed origin related to the ophthalmic (41 cases) or superior hypophyseal (39 cases) arteries. There was a marked female predominance (7:1) and high incidence of multiple aneurysms (45%) within this population. Clinical presentations included subarachnoid hemorrhage in 23 cases (29%) and visual deficits in 24 (30%); five patients exhibited both hemorrhage and visual loss. Twenty-eight aneurysms were incidentally identified. Ophthalmic artery aneurysms arose from the internal carotid artery (ICA) just distal to the ophthalmic artery, pointed superiorly or superomedially, and (when large) deflected the carotid artery posteriorly and inferiorly, closing the siphon. Abnormalities relating to vision were not identified until the aneurysm realized giant proportions. The optic nerve was typically displaced superomedially, which restricted contralateral extension until late in the clinical course; unilateral nasal field loss was seen in 12 patients. Nine patients had bilateral ophthalmic artery aneurysms which were often clipped via a unilateral craniotomy. Superior hypophyseal artery aneurysms arose just above the dural ring from the medial bend of the ICA, at the site of perforator origin to the superior aspect of the hypophysis, and had no direct association with the ophthalmic artery. The carotid artery was usually located lateral or superolateral relative to the aneurysm. These lesions could extend medially beneath the chiasm (suprasellar variant), producing a clinical and computerized tomography picture similar to a pituitary adenoma, or they could extend ventrally to burrow beneath the anterior clinoid process (paraclinoid variant). Preoperative categorization of these lesions according to their likely branch of origin provides excellent correlation with visual deficits and operative findings, and has allowed the author to clip 52 of 54 lesions, with very low operative or visual morbidity.
          Article 0 comments Cited 39 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Extradural temporopolar approach to lesions of the upper basilar artery and infrachiasmatic region.

            T Fukushima, Ryan Day, S Giannotta (1994)
            Surgical access to the parasellar, infrachiasmatic, and posterior clinoid regions has traditionally been accomplished through an intradural pterional or subtemporal approach. However, for large or complex lesions in these locations, such traditional trajectories may not afford sufficient exposure for complete obliteration of the pathological process. The authors describe an anterolateral transcavernous approach to this region that includes the following components: 1) extradural removal of the sphenoid wing and exposure of the superior orbital fissure and foramen rotundum; 2) removal of the anterior clinoid process via the anterolateral route; 3) decompression of the optic canal; 4) extradural retraction of the temporal tip; 5) transcavernous mobilization of the carotid artery and third cranial nerve; and 6) removal of the posterior clinoid process. This method results in enhanced exposure with minimal brain retraction and preservation of the temporal tip bridging veins. This approach has been used in 22 patients: 10 with basilar top aneurysms, eight with craniopharyngiomas, one with a tuberculum sellae meningioma, and two with trigeminal neuromas; the last patient had a carotid-cavernous fistula and a concomitant pituitary adenoma. Complete clip ligation was performed for all 10 basilar artery aneurysms, and gross total resection was achieved with preservation of the pituitary stalk in all tumor cases. Microscopic total resection was not possible in two cases of craniopharyngioma due to hypothalamic invasion. Two patients suffered transient postoperative hemiparesis, and one patient has persisting weakness; however, no patient followed for more than 6 months suffered any persistent cranial nerve morbidity. It is concluded that this procedure can serve as an alternative to either the transsylvian or subtemporal approaches when cranial base pathologies are large or complex.
            Article 0 comments Cited 22 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Cranial base approaches to posterior circulation aneurysms.

              Ryan Day, S Giannotta, J Fukushima (1997)
              Aneurysms arising from the posterior circulation, especially when they are large and complex, continue to present a technical challenge. The development of cranial base strategies and principles has added to surgical management options. The authors used one of four cranial base approaches for the treatment of 30 patients with large and/or complex aneurysms arising from the vertebrobasilar circulation. These approaches included the extradural temporopolar, combined petrosal, retrolabyrinthine-transsigmoid, and the extreme-lateral inferior transtubercular exposure. The indications, technique, and results of each approach in this series are discussed, and a management paradigm is suggested for such aneurysms.
              Article 0 comments Cited 17 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Asian J Neurosurg
                Journal ID (iso-abbrev): Asian J Neurosurg
                Journal ID (publisher-id): AJNS
                Title: Asian Journal of Neurosurgery
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Print): 1793-5482
                ISSN (Electronic): 2248-9614
                Publication date (Print): Apr-Jun 2018
                Volume: 13
                Issue: 2
                Pages: 482-484
                Affiliations
                [1] Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan
                Author notes
                Address for correspondence: Dr. Naoki Otani, Department of Neurosurgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. E-mail: naotani@ 123456ndmc.ac.jp
                Article
                Publisher ID: AJNS-13-482
                DOI: 10.4103/ajns.AJNS_153_16
                PMC ID: 5898138
                SO-VID: 3ce68745-1ba0-4934-ae35-6bc314e1474b
                Copyright © Copyright: © 2018 Asian Journal of Neurosurgery
                License:

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Surgery
                Keywords: anterior clinoidectomy,microneurosurgery,paraclinoid aneurysm,suction decompression
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: anterior clinoidectomy, microneurosurgery, paraclinoid aneurysm, suction decompression

                Comments

                Comment on this article