Monitoring of Cortical Somatosensory Evoked Potentials to Determine the Safety of Sacrificing the Anterior Cerebral Artery

Neurosurgery ◽  
1982 ◽  
Vol 11 (1_pt_1) ◽  
pp. 64-67 ◽  
Author(s):  
Betty L. Grundy ◽  
Paul B. Nelson ◽  
Agnes Lina ◽  
Roberto C. Heros
Keyword(s):  
Arteriovenous Malformation ◽  
Evoked Potentials ◽  
Cerebral Artery ◽  
Somatosensory Evoked Potentials ◽  
Intraoperative Monitoring ◽  
Anterior Cerebral Artery ◽  
Sensorimotor Function ◽  
Left Lower Extremity ◽  
The Right ◽  
Site Of Stimulation

Abstract Cortical somatosensory evoked potentials (SSEPs) reflect the functional integrity of somatosensory pathways from the site of stimulation to the primary somatosensory cortex. We used intraoperative monitoring of cortical SSEPs to determine whether the right anterior cerebral artery (RACA), the major feeding vessel of a large arteriovenous malformation (AVM), could be sacrificed without compromising sensorimotor function in the left lower extremity. The SSEPs recorded after test occlusion of the RACA showed preservation of the initial cortical positivity, and the RACA was divided. The AVM was excised completely, and the patient suffered no neurological deficit.

scholarly journals Dissecting Aneurysms of Bilateral Anterior Cerebral Artery Complicated by Subarachnoid Hemorrhage after Cerebral Infarction: A Case Report

2008 ◽  
Vol 1 ◽  
pp. CCRep.S833
Author(s):  
Akihiro Kurosu ◽  
Shizuo Hatashita ◽  
Hideo Ueno
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Infarction ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Vascular Reconstruction ◽  
Dissecting Aneurysm ◽  
Vascular Anastomosis ◽  
Left Lower Extremity ◽  
The Right ◽  
Dissecting Aneurysms

Introduction Intracranial dissecting aneurysms have been increased due to recent advancements in diagnostic imaging. However there have been little article with subarachnoid hemorrhage and cerebral infarction occurring almost at the same time. We performed the surgical treatment and obtained good result. Case presentation A 47-year-old male presented to our hospital with chief complaints of sudden headache and mild paralysis of the left lower extremity. Brain imaging at admission revealed cerebral infarction in the right frontal lobe and subarachnoid hemorrhage in the frontal convexy and anterior interhemispheric fissure. The left and right internal carotid angiography showed a bulging cerebral aneurysm at the left A1–A2 junction and stenosis and arterial dissections in the peripheral of the bilateral anterior cerebral artery. Wrapping was performed for the dissecting aneurysm of the left anterior cerebral artery. For the right anterior cerebral artery, trapping was performed at the A2 segment without vascular anastomosis. The patient's postoperative course was uneventful. Conclusion A consensus has not been reached on the treatment for intracranial dissecting aneurysms. Proximal trapping without vascular reconstruction was performed for the right anterior cerebral artery without vascular anastomosis to prevent rebleeding. However no symptoms of neurological deficiency were observed. Proximal trapping of dissecting aneurysm seems to be a good option when patient's functional and life prognosis are taken into account in case that vascular reconstruction will be anticipated difficulty.

scholarly journals The experience of simultaneous endovascular occlusion of arteriovenous malformation and saccular aneurism in a parturient woman

2020 ◽  
Vol 30 (4) ◽  
pp. 79-87
Author(s):  
D.V. Shchehlov ◽  
S.V. Konotopchyk ◽  
I.N. Bortnyk ◽  
O.E. Svyrydiuk ◽  
M.Yu. Mamonova
Keyword(s):  
Arteriovenous Malformation ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Parietal Lobe ◽  
Endovascular Embolization ◽  
Saccular Aneurysm ◽  
Anterior Communicating Artery ◽  
Parturient Woman ◽  
Left Lateral Ventricle ◽  
The Right

The clinical case of simultaneous endovascular bloodstream exclusion of arteriovenous malformation and saccular aneurysm in parturient woman is presented. Onyx liquid adhesive composition and monospiral aneurysm occlusion technique were used. Patient X., 31, was hospitalized to the clinic on the 10th day of the postpartum period. From the anamnesis: twice (at 20th and 27th weeks of pregnancy) patient suffered intraventricular hemorrhage due to the rupture of arteriovenous malformation in the posterior third of the corpus callosum, left lateral ventricle and left parietal lobe of the brain. After the first hemorrhage a conservative treatment tactic was determined, given the high risk of complications associated with the surgical intervention for the mother and fetus. After the second hemorrhage endovascular embolization of malformation was suggested, however, the patient and her husband refused surgery, preferring conservative therapy with subsequent surgical treatment after delivery. In addition to the malformation, according to the data of selective cerebral subtraction angiography multiple cerebral saccular aneurysms of the left Anterior Cerebral – Anterior Communicating Artery and 2 Anterior Cerebral Artery aneurysms (A2-A2, A3-A4-segments) on the right side were diagnosed. Endovascular subtotal embolization of arteriovenous malformation and occlusion of the right Anterior Cerebral Artery (A2-A3-segment) saccular aneurysm were performed during the operation. A control angiographic examination after 3 months showed a complete exclusion of these arteriovenous malformation and saccular aneurysm and disappearance of all aneurysms of the left Anterior Cerebral Artery – Anterior Communicating Artery and right Anterior Cerebral Artery (A3-A4-segment).

scholarly journals Complete Recovery from Blindness in Case of Compressive Optic Neuropathy due to Unruptured Anterior Cerebral Artery Aneurysm

2017 ◽  
Vol 8 (1) ◽  
pp. 157-162
Author(s):  
Yurie Fukiyama ◽  
Hidehiro Oku ◽  
Yusuke Hashimoto ◽  
Yuko Nishikawa ◽  
Masahiro Tonari ◽  
...  
Keyword(s):  
Visual Field ◽  
Optic Neuropathy ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Artery Aneurysm ◽  
Complete Recovery ◽  
Visual Field Defects ◽  
Anterior Cerebral Artery Aneurysm ◽  
The Right ◽  
Cerebral Artery Aneurysm

It is not common for an isolated visual symptom to be the first indication of an aneurysm compressing the optic nerve. The compression can lead to blindness, and a recovery from the blindness is rare. We report a female with a left painless optic neuropathy caused by an unruptured anterior cerebral artery aneurysm. The patient had a temporal hemianopic visual field defect, which progressed to blindness in the left eye, while the right visual function was not affected. A coil embolization of the aneurysm completely restored her visual acuity to 20/20. These findings suggest that aneurysmal lesions should be ruled out in case of unilateral optic neuropathy with hemianopic visual field defects and progressive visual loss.

scholarly journals The Iatrogenic Development of an Anterior Cerebral Artery Pseudoaneurysm during Lamina Terminalis Fenestration–Genesis, Diagnosis and Therapy: Lessons Learned

2020 ◽  
Vol 10 (6) ◽  
pp. 357 ◽  
Author(s):  
Robert Bartoš ◽  
Jan Lodin ◽  
Aleš Hejčl ◽  
Martin Sameš ◽  
Filip Cihlář
Keyword(s):  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Lessons Learned ◽  
Lamina Terminalis ◽  
Vascular Injuries ◽  
Proper Treatment ◽  
Artery Pseudoaneurysm ◽  
Potential Risks ◽  
The Right ◽  
Over Time

Intracranial pseudoaneurysms (PSA) are scarcely presented in the literature. We describe the case of an intracranial PSA on the right anterior cerebral artery, which developed during the complicated surgical treatment of a ruptured right middle cerebral aneurysm. The pseudoaneurysm grew over time and was co-incidentally diagnosed 3 months after the original surgery. The PSA was successfully treated by coiling. In cases of vascular injuries during complicated brain surgery, the timely and careful radiological diagnosis of such a lesion is necessary to allow its fast and proper treatment and thus prevent the patient from potential risks.

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