Endoport-assisted microsurgical treatment for a ruptured posterior cerebral artery aneurysm: A technical note
10.7461/jcen.2022.E2021.05.002
- Author:
Juan Luis GÓMEZ-AMADOR
1
;
Marcos Vinicius SANGRADOR-DEITOS
;
Rodrigo URIBE-PACHECO
;
Gerardo Yoshiaki GUINTO-NISHIMURA
;
Michel Gustavo MONDRAGÓN-SOTO
Author Information
1. Department of Skull-Base Neurosurgery, National Institute of Neurology and Neurosurgery Manuel Velasco Sáurez, Mexico City, Mexico
- Publication Type:Technical Note
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2022;24(1):73-78
- CountryRepublic of Korea
- Language:English
-
Abstract:
Posterior Cerebral Artery aneurysms are scarce, yet its territory is frequently associated to large and giant aneurysms. Treatment is mostly a binary option between microsurgical clipping and endovascular coiling. Hybrid approaches are an option too, whereas innovation with less frequent techniques such as endoscope-controlled and endoscope-assisted procedure may provide a safer surgical approach with same successful results. Hereby we report a case of a 53 years old male examined at the ER after presenting generalized seizures and altered state of consciousness. Upon arrival, neurological evaluation revealed homonymous right hemianopia. Computed tomography (CT) scan revealed a subarachnoid hemorrhage and left parieto-occipital intraparenchymal hemorrhage with intraventricular extension; computed tomography angiogram (CTA) revealed an aneurysm at the left posterior cerebral artery (PCA) in its P4 segment. We performed a vascular exploration with drainage of the occipital and intraventricular hematoma through a single endoscopic port through transulcal approach guided by neuronavigation, in addition to clipping and aneurysmectomy. The combination of microsurgical clipping with previous Endoport-guided endoscopic procedure may be a surgical-operative option that not only may facilitate the approach to the desired lesion, but also provides a safer surgical scenario.
