Clipping posterior communicating artery aneurysms of medial posterior inferior type by conventional pterional craniotomy: a clinical observation study
10.3760/cma.j.cn115354-20201212-00964
- VernacularTitle:翼点入路开颅手术夹闭后内侧下型后交通动脉瘤的临床观察
- Author:
Zheng LIU
1
;
Yinxing HUANG
;
Qizuan CHEN
;
Mingchao SHANG
;
Shousen WANG
;
Shangming ZHANG
Author Information
1. 解放军联勤保障部队第九〇〇医院神经外科，福州 350025
- Keywords:
Posterior communicating artery aneurysm;
Neurosurgical clipping;
Posterior communicating artery;
Anterior choroidal artery
- From:
Chinese Journal of Neuromedicine
2021;20(12):1225-1230
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clipping methods of ruptured posterior communicating artery (PCoA) aneurysms of medial posterior inferior type (aneurysms located at the medial posterior inferior part of internal carotid artery or occluded by the internal carotid artery) during conventional pterional craniotomy.Methods:Seven patients with ruptured PCoA aneurysms, admitted to our hospital from January 2004 to January 2020, were chosen in our study. The clinical data and surgical efficacies of these patients were retrospectively analyzed.Results:The anterior choroidal artery (AChA) was accidentally clipped in 2 patients during the surgery, of which one was released after adjustment and one was avoided after multiple adjustments. Due to severe acute brain swelling, the brain tissues of the anterior temporal lobe were removed for about 20 mm in 2 patients, and the anterior temporal lobe was retracted posteriorly by platens in 5 patients. All aneurysms disappeared in the postoperative CTA images, no residual neck was found, and the parent artery remained unobstructed. One patient had cerebral infarction in the AChA supplying area. All patients were followed up for 1-6 years, with an average of 27.6 months. Six patients recovered completely without neurological dysfunction. One patient had contralateral hemiplegia, with muscle strength grading III, walking on crutches, and basic living by himself.Conclusion:It's difficult to clip the ruptured PCoA aneurysms of medial posterior inferior type by conventional pterional craniotomy; so straight and curved aneurysm clips can be used to clip aneurysms by expanding the inter-cisternal space around the aneurysms.
