Optochiasmal arachnoiditis following muslin wrapping of ruptured anterior communicating artery aneurysms

McFadzean, Robert M.; Hadley, Donald M.; McIlwaine, Gawn G.

doi:10.3171/jns.1991.75.3.0393

Cited by 44 publications

(31 citation statements)

References 9 publications

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“…Further endocrinological assessment identified partial diabetes insipidus and hypothyroidism. [1,8,10,11]. In these cases, the use of muslin has been incriminated in the resulting neurological or cranial nerve deficits by inducing a "foreign b o d y " reaction.…”

Section: Case Reportmentioning

confidence: 99%

“…In these cases, the use of muslin has been incriminated in the resulting neurological or cranial nerve deficits by inducing a "foreign b o d y " reaction. The reaction to muslin results in localised arachnoiditis [1,7,8,11], or the formation of a mass due to a g r a n u l o m a [2,4,9,10]. These appearances p r o b a b l y represent the extremes of a spectrum.…”

Section: Case Reportmentioning

confidence: 99%

“…I s c h a e m i a either from constriction of the nerve [8] or vascular occlusion of the small vessels supplying the nerves [1] have been suggested as being the likely cause of these deficits. This is a rare c o m p l i c ation.…”

Section: Introductionmentioning

confidence: 99%

“…This is a rare c o m p l i c ation. Considering the n u m b e r of w r a p p e d aneurysms, the n u m b e r of reported cases of granulomas r e m a i n low [1,2,4,[7][8][9][10][11]. We present two patients who d e v e l o p e d progressive visual impairment, one following the w r a p p i n g of an anterior c o m m u n i c a t i n g artery ( A C o A ) aneurysm, and the other of an ophthalmic artery aneurysm.…”

Section: Introductionmentioning

confidence: 99%

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Muslin induced granuloma following wrapping of intracranial aneurysms: The role of infection as an additional precipitating factor

et al. 1997

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Two patients who developed what appeared to be a granulomatous reaction following muslin wrapping of unclipped aneurysms are reported. They presented with cranial nerve palsies and at operation were found to have an abscess around the wrapped aneurysms. In one of these two patients Staphylococcus epidemidis was isolated from the pus. This, together with further evidence from reported cases in the literature, would suggest that infection may play an additional role at least in some cases in the onset of a foreign-body granulomatous reaction seen following wrapping of aneurysms.

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Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Muslin induced granuloma following wrapping of intracranial aneurysms: The role of infection as an additional precipitating factor

et al. 1997

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“…Visual loss and oculomotor nerve palsy have been reported after gauze wrapping of anterior circulation aneurysms 8,9 . McFadzean et al 10 described five cases of optochiasmic arachnoiditis after muslin wrapping of anterior communicating artery aneurysms. The wrapping agent should then not be placed in direct contact with cranial nerves.…”

Section: Discussionmentioning

confidence: 99%

The clip-wrap technique in the treatment of intracranial unclippable aneurysms

Figueiredo

Foroni

Mônaco

et al. 2010

Arq. Neuro-Psiquiatr.

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Fusiform and dolichoectatic aneurysms are challenging lesions to treat with direct clipping. Treatment of these aneurysms often requires alternative surgical strategies, including extracranial-intracranial bypass, wrapping, or clip-wrap techniques. Nonetheless, these alternatives methods of treatment have been underused and frequently overlooked. Objective: To report a series of nine cases of otherwise untreatable aneurysms managed using the clip-wrap technique and discuss its surgical nuances. Method: In the last four years, 9 cases of ruptured aneurysms treated by the clip-wrap techniques were identified in the Division of Neurological Surgery, University of São Paulo, School of Medicine. results: The aneurysms were located at middle cerebral artery (2), anterior choroidal artery (1), anterior communicating artery (1), carotid ophthalmic (3), posterior cerebral artery (1) and posterior-inferior cerebellar artery (1). Three were dolichoectatic, 4 were unsuitable to complete surgical clipping because parent or efferent vessels arises from the aneurysm sac (1 MCA, 1 AcomA, 1 CO, 1 PICA aneurysms) and two, although ruptured aneurysms, were too small (<2mm) to be directly clipped. No early or late rebleeding was observed after 2 years mean follow-up. One patient deceased due to pulmonary tromboembolism. conclusion: Clip-wrap techniques for the treatment of fusiform and otherwise unclippable aneurysms seem to be safe and it can be associated with a low rate of acute or delayed postoperative complications. It can prevent rebleeding and represents an improvement when compared with the natural history.

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Clipping Techniques for Partially Thrombosed Giant Aneurysms

Sugita

Shibuya

Negoro

et al. 1994

New Trends in Management of Cerebro-Vascular Malformations

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SummarySurgery for partially thrombosed giant and large aneurysms is technically more difficult than for nonthrombosed aneurysms. Treatment strategies consisting of intravascular embolization, direct clipping and bypass surgery must be made according to the location, size and degree of thrombosis of the aneurysms and collateral flow. Among 64 giant and large aneurysms 27 were partially thrombosed. Direct clipping was performed in 18, combined interventional and direct surgery in 3 and interventional surgery alone in 6 patients. Surgical results were good in 24, poor in two with death in one patients. Good indications for intravascular surgery are aneurysms in the intracavernous carotid artery, vertebral artery, basilar tip and those unruptured aneurysms with less mass effect in elderly patients. For direct clipping, parent artery is trapped after heparinization and aneurysm is opened at a place more than 5 mm away from the parent artery in order to obtain enough space for multiple clips. After thrombectomy best fitting clips were selected from over 80 different shapes of SUgita clips. Large clips of over 21 mm, fenestrated clips and booster clips were most frequently used. Three to six clips were needed to occlude the wide and thick neck of each aneurysm. Direct clipping with aneurysmectomy was the most preferable procedure from the point of decompression and complete cure for the ruptured, partially thrombosed giant and large aneurysms with mass effects.

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Optochiasmal arachnoiditis following muslin wrapping of ruptured anterior communicating artery aneurysms

Cited by 44 publications

References 9 publications

Muslin induced granuloma following wrapping of intracranial aneurysms: The role of infection as an additional precipitating factor

Muslin induced granuloma following wrapping of intracranial aneurysms: The role of infection as an additional precipitating factor

The clip-wrap technique in the treatment of intracranial unclippable aneurysms

Clipping Techniques for Partially Thrombosed Giant Aneurysms

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