Search results for "intracranial aneurysm"
showing 10 items of 51 documents
Reduced risk of ICA ligation after balloon occlusion test
1982
Transcranial Doppler diagnosis of cerebral vasospasm following subarachnoid haemorrhage: correlation and analysis of results in relation to the age o…
1994
A retrospective analysis was undertaken to determine whether cerebral vasospasm following subarachnoid haemorrhage (SAH) correlates with the age of patients. For at least 3 weeks after bleeding 80 subjects underwent very close follow-up with clinical examination and transcranial Doppler records of the blood velocities within the basal cerebral arteries. Firstly a correlation between measured maximal mean blood flow velocities and age was made. Secondly, according to their age and the maximum of recorded mean velocities (v), the patients were divided into groups as follows: age 55 years or less, age more than 55 years; and maximum velocity v190 cm/s, 90 cm/sv2120 cm/s, 120 cm/sv3160 cm/s, v4…
The preoperative assessment of stroke risk in lesions involving the internal carotid artery.
1995
Patients with vascular or tumourous lesions involving the internal carotid artery are at risk of damage or occlusion of this vessel during surgical or endovascular procedures. To assess the stroke risk transcranial Doppler aided carotid compression tests were performed in 82 patients. Based on changes of blood flow velocity (BFV), pulsatility index, systolic/diastolic ratio and length of transient hyperaemic response three groups could be differentiated. Patients in group A (31%) showed only a slight reaction of BFV and were at minimal risk in case of carotid occlusion. Patients in group B (52%) underwent a distinct decrease of Doppler readings with partial improvement and were considered t…
The keyhole concept in aneurysm surgery: results of the past 20 years.
2011
Item does not contain fulltext BACKGROUND: Improvements in preoperative imaging and intraoperative visualization have led to a refinement in surgical techniques. OBJECTIVE: Report of a 20-year experience with application of the keyhole technique as a contribution to the ongoing debate on the impact of limited craniotomies in aneurysm surgery. METHODS: Over a 20-year period, 1000 consecutive patients with 1297 aneurysms were surgically treated in 1062 operations: 651 in the acute stage after SAH and 411 with unruptured aneurysms. The outcome was assessed with the modified Rankin scale and approach-related complications. RESULTS: The majority of the cases were treated by 4 different keyhole a…
The Supraorbital Keyhole Approach to Supratentorial Aneurysms: Concept and Technique
1998
Background Anterior surgical approaches to the base of the brain have always required relatively large craniotomies, most larger than the lesion itself. Especially in aneurysm surgery, the size of the lesion is not always proportionate to the extent of brain exposure. The improvement of surgical techniques and diagnostic imaging, as well as the introduction of neuroendoscopy and new surgical instruments, enable us now to treat various intracranial lesions through small keyholes. In particular, cerebral aneurysms, because of their anatomic characteristics, are apt to be treated by the keyhole approach. The supraorbital keyhole approach has the broadest field of indications, although its tech…
Endovascular management of carotid artery dissections with the use of new generation stents and protection systems
2016
Dissection of the internal carotid artery (ICA) is a rare disease, but in young patients is responsible for about 20% of cerebral events. We presented three different cases of ICA dissection, including one iatrogenic and two spontaneous ones, which were successfully managed endovascularly, with the use of different techniques, different protection devices and stents. In this article, the clinical management and details of procedures were described.
Endoscopy in aneurysm surgery.
2011
BACKGROUND: Surgical clipping with complete occlusion of the aneurysm and preservation of parent, branching, and perforating vessels remains the most definitive treatment for intracranial aneurysms. OBJECTIVE: To evaluate the benefit of endoscopic application during microsurgical procedures in a retrospective study. METHODS: One hundred eighty aneurysms were microsurgically treated in 124 operations. Three different applications of endoscopic visualization were used, depending on the respective requirements: inspection before clipping, clipping under endoscopic view, and postclipping evaluation. RESULTS: Of 1380 aneurysms, 292 procedures were done with application of the endoscope. Of these…
Measurement of Cortical Microcirculation During Intracranial Aneurysm Surgery by Combined Laser-Doppler Flowmetry and Photospectrometry
2011
Accidental vessel occlusion is one major risk of intracranial aneurysm surgery potentially causing cerebral ischemia. The intraoperative assessment of cerebral ischemia remains a technological challenge.As a novel approach, cortical tissue integrity was monitored using simultaneous measurements of regional capillary-venous cerebral blood flow (rvCBF), oxygen saturation (Srvo2), and hemoglobin amount (rvHb) during aneurysm surgery.Fifteen patients scheduled for aneurysm surgery of the anterior and posterior circulation were included. A fiber optic probe was placed on the cortex associated with the distal branch of the aneurysmatic vessel. Blinded measurements by combined laser-Doppler flowme…
Contralateral and ipsilateral microsurgical approaches to carotid-ophthalmic aneurysms.
1997
Objective The vicinity of carotid-ophthalmic aneurysms to the roof of the cavernous sinus, to the anterior clinoid process, and to the optic nerve or the optic chiasm requires well-defined surgical techniques. Although microsurgical techniques with ipsilateral direct approaches to these aneurysms have been described in detail, studies about contralateral strategies for the microsurgical treatment of carotid-ophthalmic aneurysms are rare and are mainly confined to case reports. The aim of this study is to describe how to decide on the ipsilateral and contralateral microsurgical approaches to such aneurysms and to demonstrate the surgical techniques for the ipsilateral and contralateral expos…
Surgically verified variations in the A1 segment of the anterior cerebral artery
1991
✓ Two patients with rare variations of the A1 segment of the anterior cerebral artery are presented. One patient had a perforation of the optic tract by an abnormal course of the A1 segment, and the other harbored an aneurysm of the A1 segment running below the optic nerve. The authors present a summary of A1 segment variations described in the literature.