The microsurgical anterior interhemispheric approach suitably applied to ruptured aneurysms of the anterior communicating artery in the acute stage

1982 ◽  
Vol 63 (1-4) ◽  
pp. 85-99 ◽  
Author(s):  
Z. Ito
Keyword(s):  
Acute Stage ◽  
Anterior Communicating Artery ◽  
Ruptured Aneurysms ◽  
Interhemispheric Approach ◽  
Anterior Interhemispheric Approach

Low Anterior Interhemispheric Approach - A Narrow Corridor to Aneurysms of the Anterior Communicating Artery

2001 ◽  
Vol 143 (9) ◽  
pp. 885-891 ◽  
Author(s):  
H. El-Noamany ◽  
F. Nakagawa ◽  
K. Hongo ◽  
Y. Kakizawa ◽  
S. Kobayashi
Keyword(s):  
Anterior Communicating Artery ◽  
Interhemispheric Approach ◽  
Anterior Interhemispheric Approach

Orbitocraniobasal Approach for Anterior Communicating Artery Aneurysms

Neurosurgery ◽  
1986 ◽  
Vol 18 (3) ◽  
pp. 367-369 ◽  
Author(s):  
Kazuhiko Fujitsu ◽  
Takeo Kuwabara
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Surgical Treatment ◽  
Skull Base ◽  
Acute Stage ◽  
Anterior Communicating Artery ◽  
Ruptured Aneurysms ◽  
Anterior Communicating Artery Aneurysms ◽  
The Brain

Abstract We describe an orbitofrontotemporobasal craniotomy technique that allows excellent access to anterior communicating artery aneurysms. This orbitocraniobasal approach is particularly useful for the surgical treatment of ruptured aneurysms in the acute stage of subarachnoid hemorrhage, when retraction of the brain needs to be kept to a minimum. With this approach, retraction of the orbital contents decreases the amount of retraction of the brain to such an extent that a brain spatula is not necessary for access to the anterior communicating artery complex. The procedure is described, as is a modification of the approach for removal of large tumors on the skull base.

scholarly journals Paramedian thalamic infarction caused by cisternal drain placement in open clipping for aneurysmal subarachnoid hemorrhage: Two case reports

2020 ◽  
Vol 11 ◽  
pp. 164
Author(s):  
Sho Tsunoda ◽  
Tomohiro Inoue ◽  
Hideaki Ono ◽  
Kazuaki Naemura ◽  
Atsuya Akabane
Keyword(s):  
Aneurysmal Subarachnoid Hemorrhage ◽  
Case Reports ◽  
Anatomical Variation ◽  
Anterior Communicating Artery ◽  
Prepontine Cistern ◽  
Interhemispheric Approach ◽  
Thalamic Infarction ◽  
Anterior Interhemispheric Approach ◽  
Drain Placement ◽  
Cisternal Drainage

Background: Some complications associated with cisternal drainage have been reported; however, there are few reports on direct vascular injury caused by cisternal drain. We experienced two rare cases of thalamic infarction caused by cisternal drain placement during open clipping for a ruptured anterior communicating artery (AcomA) aneurysm through an anterior interhemispheric approach. Case Description: Two cases of ruptured AcomA aneurysm were treated by surgical clipping through an anterior interhemispheric approach, and then a cisternal drain was inserted from opticocarotid space toward prepontine cistern. Postoperatively, the magnetic resonance imaging showed unilateral anterior-medial thalamic infarction in both two cases. By reviewing the postoperative computed tomography and digital subtraction angiography, it was suspected that the cisternal drain, which was inserted slightly deep, obstructed the P1 perforator because of an anatomical variation involving a lowered basilar bifurcation and caused postoperative unilateral paramedian thalamic infarction. Conclusion: To avoid these complications, neurosurgeons should consider the potential for P1 perforator injury related to cisternal drain placement.

Venous infarction following the interhemispheric approach in patients with acute subarachnoid hemorrhage

1991 ◽  
Vol 74 (5) ◽  
pp. 715-729 ◽  
Author(s):  
Kazuo Tsutsumi ◽  
Yoshiaki Shiokawa ◽  
Tatsuo Sakai ◽  
Nobuhiko Aoki ◽  
Masaru Kubota ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Venous Drainage ◽  
Acute Stage ◽  
Anterior Communicating Artery ◽  
Aneurysm Surgery ◽  
Venous Infarction ◽  
Content Type ◽  
Interhemispheric Approach ◽  
Acute Subarachnoid Hemorrhage ◽  
Bridging Veins

✓ Postoperative venous infarction following aneurysm surgery was studied in 48 patients with anterior communicating artery aneurysms operated on through the interhemispheric approach at the acute stage of subarachnoid hemorrhage (SAH). Of 23 patients whose bridging veins were sacrificed during surgery, 11 (47.8%) showed venous infarction in the frontal lobes. In contrast, only one (5.9%) of 17 patients whose bridging veins were preserved developed cerebral edema. None of eight patients who were operated on after Day 11 (the day of SAH was defined as Day 0) showed this complication, although bridging veins were sacrificed in six of them. Venous infarction following acute aneurysm surgery tended to occur more frequently in patients of higher SAH grade and/or more advanced age, but these correlations were not significant. However, the correlation between the sacrifice of veins and venous infarction was significant (p < 0.025). Because this potential complication may compromise the benefit of acute aneurysm surgery and cause damage, it is important to preserve the venous system and in some instances to select another surgical approach based on the pattern of venous drainage in the frontal lobe.

Anterior Interhemispheric Approach for 100 Tumors in and Around the Anterior Third Ventricle

2010 ◽  
Vol 66 (suppl_1) ◽  
pp. ons-65-ons-74 ◽  
Author(s):  
Tomokatsu Hori ◽  
Takakazu Kawamata ◽  
Kosaku Amano ◽  
Yasuo Aihara ◽  
Masami Ono ◽  
...  
Keyword(s):  
Third Ventricle ◽  
Karnofsky Performance Scale ◽  
Subtotal Resection ◽  
Anterior Communicating Artery ◽  
Lamina Terminalis ◽  
Interhemispheric Approach ◽  
Anterior Interhemispheric Approach ◽  
Bridging Veins ◽  
Performance Scale

Abstract Objective: We report our experience with anterior interhemispheric approach for tumors in and around the anterior third ventricle, including surgical technique, instrumentation, pre- and postoperative hormonal disturbances, and resection rate. Methods: One hundred patients with 46 craniopharyngiomas, 12 hypothalamic gliomas, 12 meningiomas, 6 hypothalamic hamartomas, and 24 other lesions were operated on using an anterior interhemispheric approach with or without opening of the lamina terminalis. This surgical approach involves no frontal sinus opening; a narrow (approximately 15–20 mm in width) access between the bridging veins, which is sufficient to remove the tumor totally; and sparing of the anterior communicating artery. Specially designed long bipolar forceps and scissors are necessary for this approach, and concomitant use of angled instruments (endoscope, aspirator, and microforceps) is required frequently. The postsurgical follow-up period varied from 4 months to 18 years. Results: Total removal of the neoplasm was accomplished in 37 of 46 patients with craniopharyngiomas (80.4%), whereas subtotal resection was performed in hypothalamic gliomas. No significant differences in pre- and postoperative hormonal disturbances were observed in 37 craniopharyngiomas and 10 hypothalamic gliomas. There was no operative mortality. Visual acuity was preserved or improved in 68 of 75 patients assessed. The Karnofsky Performance Scale score did not deteriorate in 72 of 75 patients tested. Conclusion: The minimally invasive anterior interhemispheric approach, with or without opening of the lamina terminalis, is useful for removal of tumors in and around the anterior third ventricle, such as craniopharyngiomas and hypothalamic gliomas.

scholarly journals Use of the pCONus as an adjunct to coil embolization of acutely ruptured aneurysms

2016 ◽  
Vol 9 (1) ◽  
pp. 39-44 ◽  
Author(s):  
M Aguilar Pérez ◽  
P Bhogal ◽  
R Martinez Moreno ◽  
C Wendl ◽  
H Bäzner ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Acute Stage ◽  
High Rate ◽  
Adjunctive Treatment ◽  
Anterior Communicating Artery ◽  
Technical Success ◽  
Ruptured Aneurysms ◽  
Acute Subarachnoid Hemorrhage ◽  
Permanent Morbidity

IntroductionCoil embolization of ruptured aneurysms has become the standard treatment in many situations. However, certain aneurysm morphologies pose technical difficulties and may require the use of adjunctive devices.ObjectiveTo present our experience with the pCONus, a new neck bridging device, as an adjunct to coil embolization for acutely ruptured aneurysms and discuss the technical success, angiographic and clinical outcomes.MethodsWe conducted a retrospective review of our database of prospectively collected data to identify all patients who presented with acute subarachnoid hemorrhage that required adjunctive treatment with the pCONus in the acute stage. We searched the database between April 2011 and April 2016.Results21 patients were identified (13 male, 8 female) with an average age of 54.6 years (range 31–73). 8 aneurysms were located at the basilar artery tip, 7 at the anterior communicating artery, 4 at the middle cerebral artery bifurcation, 1 pericallosal, and 1 basilar fenestration. 61.8% patients achieved modified Raymond–Roy classification I or II at immediate angiography, with 75% of patients having completely occluded aneurysms or stable appearance at initial follow-up. There were no repeat aneurysmal ruptures and two device-related complications (no permanent morbidity). Four patients in our cohort died.ConclusionsUse of the pCONus is safe and effective in patients with acutely ruptured aneurysms and carries a high rate of technical success.

Sign in / Sign up

Export Citation Format

Share Document