Cardiopulmonary bypass, hypothermic circulatory arrest and barbiturate cerebral protection for the treatment of giant vertebrobasilar aneurysms in children.
Intracranial aneurysms in the pediatric population are rare lesions with a significant proportion occurring as giant aneurysms involving the vertebrobasilar system. The complex anatomy of these lesions frequently creates an extremely difficult management dilemma. We present two patients, a 9-year-old and a 13-year-old, with giant fusiform vertebrobasilar aneurysms, to illustrate the utility of cardiopulmonary bypass, hypothermic circulatory arrest and barbiturate cerebral protection for successful surgical treatment of these complex intracranial vascular lesions in children.
Greene
K A
KA
Division of Neurological Surgery, St. Joseph's Hospital and Medical Center, Phoenix, Ariz.
Marciano
F F
FF
Hamilton
M G
MG
Herman
J M
JM
Rekate
H L
HL
Spetzler
R F
RF
D000293:Adolescent; D001463:Barbiturates / Q000008:administration & dosage*; D001488:Basilar Artery / Q000503:physiopathology / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D002648:Child; D003952:Diagnostic Imaging; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007036:Hypothermia, Induced / Q000295:instrumentation*; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D016343:Monitoring, Intraoperative; D009460:Neurologic Examination / Q000187:drug effects; D011183:Postoperative Complications / Q000503:physiopathology; D011229:Preanesthetic Medication; D014711:Vertebral Artery / Q000503:physiopathology / Q000601:surgery*; D014715:Vertebrobasilar Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*
D001463:Barbiturates