Surgical clipping of a large left middle cerebral artery aneurysm

2015 ◽  
Vol 38 (videosuppl1) ◽  
pp. Video13
Author(s):  
M. Yashar S. Kalani ◽  
Peter Nakaji ◽  
Joseph M. Zabramski ◽  
Robert F. Spetzler

Middle cerebral artery aneurysms, especially those with complex morphology, are considered excellent aneurysms for surgical clipping, given the challenges that exist with current endovascular techniques. We present a case of a large, complex, left middle cerebral artery aneurysm treated with microsurgical clipping. This video highlights critical steps in obtaining proximal and distal control as well as subarachnoid dissection necessary to prepare the aneurysm for final clipping.The video can be found here: http://youtu.be/RlKH2Km9z5Y.

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Patricia Almeida ◽  
Jaclyn Railsback ◽  
James Benjamin Gleason

To date,S. alactolyticusendocarditis complicated by middle cerebral artery aneurysm has not been reported. We describe the case of a 65-year-old female with a history of hypertrophic cardiomyopathy with left ventricular outflow tract obstruction presenting with confusion and a apical holosystolic murmur. Angiography of the brain identified new bilobed left middle cerebral artery aneurysm. Serial blood cultures grewS. alactolyticus, and aortic and mitral valve vegetation were discovered on transesophageal echocardiography. The patient was treated with antimicrobial therapy, mitral and aortic valve replacements, and microsurgical clipping of cerebral aneurysm. This case serves to highlight the pathogenicity of a sparsely described bacterium belonging to the heterogenousS. boviscomplex.


1992 ◽  
Vol 50 (4) ◽  
pp. 534-538 ◽  
Author(s):  
Alexandre Varella Gianetti ◽  
Francisco Otaviano Lima Perpetuo

The authors report the case of a patient whose left middle cerebral artery aneurysm was wrapped with cotton. Occlusion of the middle cerebral artery, probably secondary to a foreign-body inflammatory reaction, developed late in the postoperative course. A computerized tomography scan revealed cerebral infarct, and an enhancing expansive lesion at the site of the aneurysm suggesting the formation of a granuloma. These findings are discussed and the literature is reviewed.


2020 ◽  
pp. 245-253
Author(s):  
Samer S. Hoz ◽  
Saja A. Albanaa ◽  
Ali M. Neamah ◽  
Farah W. Abdulmohsin ◽  
Zahraa Al-Sharshahi

Background: Spontaneous subarachnoid haemorrhage is an emergent condition that leads to profound morbidity and mortality. It is mainly caused by a ruptured intracranial aneurysm. Herein we described the relationship of different factors and their impact on the outcome of patients who underwent a surgical clipping exclusively to the ruptured middle cerebral artery aneurysm. Methods: We retrospectively analyzed the medical records of patients admitted to the Neurosurgery Teaching Hospital (NTH) in Baghdad for the period between January 2017-April 2019 of patients who underwent microsurgical clipping for ruptured middle cerebral artery aneurysm. Demographic, clinical, radiological and surgical data were extracted. A univariate analysis was used to illustrate the relationship between the variables and outcome which was assessed using the five scores of the Glasgow Outcome Scale where patients were dichotomized into two groups; favourable (IV + V) and unfavourable (I, II, III). Results: Within this cohort, a total of 50 patients were studied and the analysis revealed that 92% (N=46) had a favourable outcome and 8% (N=4) had an unfavourable outcome at discharge. The in-hospital mortality was 6%(N=3). Factors that were significantly associated with poor outcome were giant aneurysms, the presence of other unruptured aneurysms, post-operative clinical vasospasm, presence of contralateral weakness, lower pre/post-operative Glasgow coma scores, higher Hunt and Hess, World Federation of Neurosurgical Societies (WFNS) and modified-WFNS grades. Conclusion:  The factors with a significant impact on the outcome of patients with surgically clipped ruptured middle cerebral artery aneurysms were GCS, WFNS, m-WFNS, H&H, contralateral muscle weakness, size of the aneurysm, presence of other unruptured aneurysms and clinical vasospasm.


2015 ◽  
Vol 39 (videosuppl1) ◽  
pp. V2
Author(s):  
Piyush Kalakoti ◽  
Shyamal C. Bir ◽  
Richard D. Murray ◽  
Osama Ahmed ◽  
Anil Nanda

Broad-necked middle cerebral artery aneurysms present unique challenges for the vascular neurosurgeon, who must contend with smaller vessels and often a complex clipping strategy. Due to their superficial location, these lesions are still commonly selected for microsurgical clipping. We present a case of a 42-year-old woman with significant vascular disease with a right middle cerebral artery aneurysm. We discuss the key surgical steps, demonstrate the microsurgical dissection and intraoperative rupture encountered and the final clipping strategy, as well as the postoperative course in this operative video presentation.The video can be found here: http://youtu.be/qZ2gvqz7XdQ.


2001 ◽  
Vol 7 (2) ◽  
pp. 147-151 ◽  
Author(s):  
C.B. Tan ◽  
G. Rodesh ◽  
P. Lasjaunias

We present a case of growth and spontaneous regression of a middle cerebral artery aneurysm after surgical clipping. A 36-year-old woman who presented with grade II subarachnoid haemorrhage was found to have a right middle cerebral artery aneurysm. The aneurysm was surgically clipped in view of the morphology of the aneurysm. Second clipping was performed four months later as there was re-growth of the neck of the aneurysm. Again re-growth of the aneurysm was noted five months after the second clipping. As further clipping of the aneurysm would be difficult, external and internal carotid arteries bypass was the treatment option but unfortunately, the by-pass operation was unsuccessful. Interestingly, angiogram performed after the bypass surgery revealed partial thrombosis and decreasing size of the aneurysm. Complete obliteration of the aneurysm was noted without further intervention one month after the failed by-pass surgery.


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