Middle cerebral artery occlusion after pterional approach to basilar bifurcation aneurysm: technical case report.
OBJECTIVE
The authors present a case of a subacute middle cerebral artery occlusion that was sustained subsequent to a basilar apex aneurysm clipping via the pterional approach. A middle cerebral artery stroke is a rare complication of basilar bifurcation aneurysm clipping, and, to our knowledge, this complication has not been previously described in otherwise healthy patients with unruptured basilar aneurysms.


METHODS
A 36-year-old woman was found to have an unruptured 1.6 x 1.0-cm basilar tip aneurysm, as revealed by computed tomography. She elected to undergo surgical repair.


METHODS
Transsylvian dissection, exposure, and uneventful clipping of the basilar bifurcation aneurysm were performed.


CONCLUSIONS
A middle cerebral artery stroke occurring after the repair of an intact basilar aneurysm has several possible causes, including retraction injury and direct surgical injury. Awareness of this complication is important for the early recognition and management of the occlusion before infarction is established.
Division of Neurological Surgery, Northwestern University Medical School, Chicago, Illinois, USA.
S E
SE
Hua
T J
TJ
Gluckman
H H
HH
Batjer
D000328:Adult; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D001488:Basilar Artery; D002533:Cerebral Angiography; D002536:Cerebral Arteries; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000000981:diagnostic imaging