Contralateral Aneurysm Clipping

Author(s):  
Ishu Bishnoi
Keyword(s):  
1998 ◽  
Vol 20 (3) ◽  
pp. 218-224 ◽  
Author(s):  
Due Duong ◽  
Sastry Kolluri ◽  
P.J. Spittaler ◽  
R.P. Sengupta

Author(s):  
Sakshi Duggal ◽  
Priyanka Khurana ◽  
Pragati Ganjoo ◽  
Nilima Das

AbstractAneurysmal surgeries are high-risk procedures due to potential for occurrence of fatal perioperative complications. This risk is exaggerated in the presence of co-existing hypertrophic cardiomyopathy (HCM). It involves asymmetrical hypertrophy of left ventricle with mitral valve dysfunction, leading to left ventricular outflow tract obstruction. Various perioperative factors may precipitate this obstruction resulting in life-threatening consequences. We report the management of a patient with HCM undergoing anterior communicating artery aneurysm clipping and discuss the anesthetic concerns. Comprehensive approach with careful drug selection, vigilant monitoring, and preparedness for complications enabled patient safety and a good neurological outcome.


2021 ◽  
Author(s):  
Alexandrina S. Nikova ◽  
Georgios S Sioutas ◽  
Katerina Sfyrlida ◽  
Grigorios Tripsianis ◽  
Michael Karanikas ◽  
...  

Author(s):  
Yaling Liu ◽  

Introduction: Acute brain herniation is a life-threatening neurological condition that occasionally develops due to severe complications following cerebral aneurysm clipping. Strategies for managing acute brain herniation have not improved substantially during the past decade. Hyperbaric oxygen treatment (HBOT) may alleviate harmful effects of cerebral hypoxia, which is one of the most important pathophysiological features of acute brain herniation and, therefore, may be useful as an adjuvant therapy for acute brain herniation. A case treated with adjuvant HBOT is reported. Case report: A 60-year-old asymptomatic man presented with a recurring left middle cerebral artery bifurcation aneurysm with previous stent-assisted embolisation. After craniotomy for surgical clipping of the aneurysm, disturbance of consciousness and right hemiplegia occurred. Computed tomography (CT) images suggested simultaneous cerebral ischaemia and intracranial haemorrhage. Pharmacologic treatment resulted in no improvement. A CT scan acquired five days after surgery showed uncal and falcine herniation. HBOT was administered five days after surgery, and the patient’s condition dramatically improved. He became conscious, and his hemiplegia improved following seven sessions of HBOT. Simultaneously, CT images showed regression of the acute brain herniation. Conclusions: The patient had recovered completely at one year post-treatment. HBOT may be effective in the treatment of acute brain herniation following cerebral aneurysm clipping.


2017 ◽  
Vol 7 (2) ◽  
Author(s):  
Athanasios K. Petridis ◽  
Jan F. Cornelius ◽  
Marcel A. Kamp ◽  
Sina Falahati ◽  
Igor Fischer ◽  
...  

In incidental aneurysms, endovascular treatment can lead to post-procedural headaches. We studied the difference of surgical <em>clipping</em> <em>vs</em>. endovascular <em>coiling</em> in concern to post-procedural headaches in patients with ruptured aneurysms. Sixtyseven patients with aneurysmal subarachnoidal haemorrhage were treated in our department from September 1<sup>st</sup> 2015 - September 1<sup>st</sup> 2016. 43 Patients were included in the study and the rest was excluded because of late recovery or highgrade subarachnoid bleedings. Twenty-two were surgical treated and twenty-one were interventionally treated. We compared the post-procedural headaches at the time points of 24 h, 21 days, and 3 months after treatment using the visual analog scale (VAS) for pain. After surgical clipping the headache score decreased for 8.8 points in the VAS, whereas the endovascular treated population showed a decrease of headaches of 3.3 points. This difference was highly statistical significant and remained significant even after 3 weeks where the pain score for the surgically treated patients was 0.68 and for the endovascular treated 1.8. After 3 months the pain was less than 1 for both groups with surgically treated patients scoring 0.1 and endovascular treated patients 0.9 (not significant). Clipping is relieving the headaches of patients with aneurysm rupture faster and more effective than endovascular coiling. This effect stays significant for at least 3 weeks and plays a crucial role in stress relieve during the acute and subacute ICU care of such patients.


Neurosurgery ◽  
1996 ◽  
Vol 38 (3) ◽  
pp. 481-487 ◽  
Author(s):  
John N.K. Hsiang ◽  
Eisen Y. Liang ◽  
Joseph M.K. Lam ◽  
Zhu Xian-Lun ◽  
Wai S. Poon

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Junting Zhang ◽  
Hongwei Zhang ◽  
Liang Zhao ◽  
Zhanqi Zhao ◽  
Ying Liu

This study aimed to explore the effect and mechanism of lidocaine pretreatment combined with dexmedetomidine on oxidative stress in patients with intracranial aneurysm clipping. Many studies have used various drugs such as lidocaine to explore the effect and mechanism of lidocaine pretreatment. A total of 80 patients with intracranial aneurysm clipping surgery were randomly divided into 4 groups: the single lidocaine group, single dexmedetomidine group, lidocaine combined with dexmedetomidine group, and control group. The thread embolism method was used to establish a stable intracranial aneurysm model of Hashimoto rats. Fifty adult rats were randomly divided into a sham operation group, ligation of the left common carotid artery and bilateral posterior branch of renal artery, lidocaine group, dexmedetomidine group, and lidocaine combined with dexmedetomidine group. The colorimetric method was used to determine the oxidative stress indicators in brain tissue: MDA content, SOD activity, and T-AOC content. The western blot method characterized the protein levels related to oxidative stress: nNOS, iNOS, and NADPH oxidase subunits p22phox, gp91phox, and p47phox. The differences in each index between the groups were statistically significant ( P < 0.05 ). Animal experiment results revealed that the content of MDA in the brain tissue of rats in the LD group was significantly lower than that in the single-drug group and sham group. The T-AOC and SOD concentrations in the LD group were significantly higher than those in the single-drug group and sham group, and the differences between the groups were statistically significant ( P < 0.05 ). The protein expression of the LD group was significantly lower than that of the drug-alone group and model group, and the difference between groups was statistically significant ( P < 0.05 ). To sum up, lidocaine pretreatment combined with dexmedetomidine can effectively maintain the hemodynamic stability of patients with intracranial aneurysm clipping and reduce postoperative oxidative stress response. Its mechanism of action may be related to the inhibition of oxidative stress damage mediated by nNOS, iNOS, and p22phox, gp91phox, and p47phox in the hippocampus. Our study has significant and applicable medical aspects in lidocaine pretreatment combined with dexmedetomidine on oxidative stress in patients.


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