U-shaped Dural Flap: A Simple Method for Transcranial Skull Base Defect Repair—Technical Report

2019 ◽  
Vol 80 (05) ◽  
pp. 396-398
Author(s):  
Cagatay Ozdol ◽  
Kamran Aghayev
Keyword(s):  
Skull Base ◽  
Artery Aneurysm ◽  
Dural Defect ◽  
Anterior Clinoid Process ◽  
Simple Method ◽  
Csf Rhinorrhea ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Csf Leakage ◽  
Planum Sphenoidale

AbstractAccidental anterior skull base defects associated with surgery are difficult to treat. There are several methods for the repair, yet postoperative rhinorrhea can occur despite the closure. A 56-year-old female patient was admitted for the treatment of a paraclinoid internal carotid artery aneurysm. The surgery included removal of the anterior clinoid process, unroofing the optic canal, decompressing the optic nerve, and clipping the aneurysm. During the surgery, the planum sphenoidale was accidentally drilled and the nasal cavity exposed. The dural defect was repaired using a U-flap technique. No postoperative cerebrospinal fluid (CSF) rhinorrhea occurred in the patient, and she was discharged on postoperative day 3. On follow-up examination the patient did not have evidence of CSF leakage.

Republished: Spontaneous subarachnoid hemorrhage due to ruptured cavernous internal carotid artery aneurysm after medical prolactinoma treatment

2016 ◽  
Vol 9 (3) ◽  
pp. e9-e9 ◽  
Author(s):  
Siri Sahib Khalsa ◽  
Todd C Hollon ◽  
Ravi Shastri ◽  
Jonathan D Trobe ◽  
Joseph J Gemmete ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Skull Base ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Anterior Clinoid Process ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Anterior Cranial Base

Aneurysms of the cavernous segment of the internal carotid artery (ICA) are believed to have a low risk of subarachnoid haemorrhage (SAH), given the confines of the dural rings and the anterior clinoid process. The risk may be greater when the bony and dural protection has been eroded. We report a case of spontaneous SAH from rupture of a cavernous ICA aneurysm in a patient whose large prolactinoma had markedly decreased in size as the result of cabergoline treatment. After passing a balloon test occlusion, the patient underwent successful endovascular vessel deconstruction. This case suggests that an eroding skull base lesion may distort normal anterior cranial base anatomy and allow communication between the cavernous ICA and subarachnoid space. The potential for SAH due to cavernous ICA aneurysm rupture should be recognised in patients with previous pituitary or other skull base lesions adjacent to the cavernous sinus.

Surgical management of internal carotid artery aneurysm near the skull base

2018 ◽  
Vol 43 (4) ◽  
pp. 262-266
Author(s):  
Hèla Ben Jmaà ◽  
Amal Lagha ◽  
Abdellaziz Diope ◽  
Fatma Jarraya ◽  
Bouthaina Bouchech ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Skull Base ◽  
Surgical Management ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm

Embolization of a giant pediatric, posttraumatic, skull base internal carotid artery aneurysm with a liquid embolic agent

2009 ◽  
Vol 4 (5) ◽  
pp. 449-452 ◽  
Author(s):  
Adam S. Reig ◽  
Scott Simon ◽  
Robert A. Mericle
Keyword(s):  
Skull Base ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Embolic Agent ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Embolic Agents ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
The Cost

Many treatments for posttraumatic, skull base aneurysms have been described. Eight months after an all-terrain-vehicle accident, this 12-year-old girl presented with right-side Horner syndrome caused by a 33 × 19–mm internal carotid artery aneurysm at the C-1 level. We chose to treat the aneurysm with a new liquid embolic agent for wide-necked, side-wall aneurysms (Onyx HD 500). We felt this treatment would result in less morbidity than surgery and was less likely to occlude the parent artery than placement of a covered stent, especially in a smaller artery in a pediatric patient. Liquid embolic agents also appear to be associated with a lower chance of recanalization and lower cost compared with stent-assisted coil embolization. After the patient was treated with loading doses of aspirin, clopidogrel bisulfate, and heparin, 99% of the aneurysm was embolized with 9 cc of the liquid embolic agent. There were no complications, and the patient remained neurologically stable. Follow-up angiography revealed durable aneurysm occlusion after 1 year. The cost of Onyx was less than the cost of coils required for coil embolization of similarly sized intracranial aneurysms at our institution. Liquid embolic agents can provide a safe, efficacious, and cost-effective approach to treatment of select giant, posttraumatic, skull base aneurysms in pediatric patients.

Sign in / Sign up

Export Citation Format

Share Document