A Case of Large Anterior Paraclinoid Aneurysm with Intraoperative Premature Rupture

Abstract We report here troubleshooting of intraoperative premature rupture with large anterior paraclinoid aneurysm, which was successfully clipped. A 61-year-old woman with left nasal hemianopia was referred to our institute. Preoperative three-dimensional computed tomography angiography and a lef...

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Bibliographic Details
Main Authors: Shinya Ichimura, Makoto Inaba, Hiroshi Kagami
Format: Article
Language:English
Published: Georg Thieme Verlag KG 2012-07-01
Series:Journal of Neurological Surgery Reports
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0032-1321504
Description
Summary:Abstract We report here troubleshooting of intraoperative premature rupture with large anterior paraclinoid aneurysm, which was successfully clipped. A 61-year-old woman with left nasal hemianopia was referred to our institute. Preoperative three-dimensional computed tomography angiography and a left internal carotid artery angiogram showed a large left anterior clinoid aneurysm adjacent to the anterior clinoid process. Aneurysm was ruptured prematurely and tentative clipping of the dome of the aneurysm was done incidentally to stop bleeding and to reduce the volume of the aneurysm. The anterior clinoid process and superior wall of the orbit were drilled out safely, since the tentative clipping had created sufficient space between the aneurysm and the anterior clinoid process to perform the procedure. The proximal neck was observed and tandem clipping was applied to the aneurysm. Intraoperative and postoperative angiography revealed complete disappearance of the aneurysm.
ISSN:2193-6358
2193-6366