Experience in the Endovascular Management of 76 Patients with Middle Cerebral Artery Aneurysms

Bulsara, Ketan R.; Tolbert, Marshall E.; Alexander, Michael J.

doi:10.1227/00006123-200608000-00040

Cited by 3 publications

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“…Bulsara et Al. 2 reported the results in 71 selected cases. Cases with intracerebral hematoma causing significant mass effect and cases where normal branches arose from the sac of the aneurysm were excluded from the endovascular approach.…”

Section: Endovascular Results In Mca Aneurysmsmentioning

confidence: 99%

Endovascular Treatment of Middle Cerebral Artery Aneurysms

et al. 2008

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The endovascular approach is described in 113 middle cerebral artery (MCA) aneurysms. The treatment failed in six cases with no adverse clinical consequences. Out of the 107 treated cases, it was possible to obtain a complete occlusion in 50 aneurysms (47%), whereas a residual aneurysm neck was observed in 54 cases (50%). Follow-up angiograms were performed in 60 cases, showing a 22% rate of further thrombosis of the aneurysm. Recanalization of the aneurysm was observed in 8% of cases, which required retreatment. The technique-related permanent morbidity rate was 9% while the mortality rate was 2%. A review of the surgical and endovascular literature is presented. The endovascular approach is particularly indicated when normal MCA branches do not arise from the aneurysm base. It must be meticulously planned in all other cases. Endovascular coil treatment of MCA aneurysms is feasible, with acceptable morbi-mortality rates.

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Section: Endovascular Results In Mca Aneurysmsmentioning

confidence: 99%

Endovascular Treatment of Middle Cerebral Artery Aneurysms

et al. 2008

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Morphometric three-dimensional computed tomography anatomy of the hypoglossal canal

et al. 2008

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Optimal surgical exposure during the transcondylar approach may result in injury to the hypoglossal nerve. This study evaluated the utility of three-dimensional computed tomography (3-D CT) as a means of obtaining detailed anatomic information in an individual patient prior to surgery involving the hypoglossal canal. We studied 20 hypoglossal canals in ten patients using 3-D CT reconstructed from 1-mm CT slices. Detailed anatomic measurements were performed to define the relationship of the hypoglossal canal to the occipital condyles and clivus. The relationship of the hypoglossal canal to the occipital condyles and clivus were extremely variable. From the outer table of the clivus in the midline, the extracranial opening of the hypoglossal canal was 20.3 + 2.7 mm (range 15.7-24.7 mm). The intracranial opening was 7.4 + 2.3 mm (range 6.2-11.5 mm) from the inner table of the clivus. From the superior aspect of the condyle, the inner opening was 11.0 + 1.4 mm (range 8.7-12.7 mm) and the outer opening was 19.1 + 2.4 mm (range 14.3-22.8 mm). From the lowest point of the condyle, the outer opening was 12.4 + 2.1 mm (range 9.1-15.6 mm). The posterior condylar emissary vein was 12.2 + 3.0 mm from the intracranial opening of the hypoglossal canal. Three-dimensional CT is a useful tool for assessing critical anatomic relationships and tailoring surgical approaches for individual patients. The amount of bone that can be safely removed without violating the hypoglossal canal can be determined preoperatively for each patient.

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Proceedings of the 2012 Spring meeting of the Society of British Neurological Surgeons

2012

British Journal of Neurosurgery

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Experience in the Endovascular Management of 76 Patients with Middle Cerebral Artery Aneurysms

Cited by 3 publications

References 0 publications

Endovascular Treatment of Middle Cerebral Artery Aneurysms

Endovascular Treatment of Middle Cerebral Artery Aneurysms

Morphometric three-dimensional computed tomography anatomy of the hypoglossal canal

Proceedings of the 2012 Spring meeting of the Society of British Neurological Surgeons

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