Traumatic intracranial aneurysms complicating anterior skull base surgery.
Traumatic cerebral aneurysm formation following closed head injury is uncommon, although well documented in the literature. Aneurysmal development following surgical procedures on the anterior skull base is extremely rare. This article reports successful neurosurgical management of 3 cases of anterior circulation aneurysms that developed following relatively straightforward rhinological procedures. These cases illustrate the vulnerability of the vessels of the anterior circle of Willis; they also document the sites of penetration of the anterior skull base. As reported in the literature, most such aneurysms occur following transsphenoidal surgery. The clinical procedures, radiological follow-up, and the surgical management are outlined; three cases are utilized to illustrate this complication. The causes of such iatrogenic injury are discussed, with emphasis on strategies for the avoidance of such injuries.
Grigorian
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A
Division of Neurosurgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, DOC #7300, 90 Bergen Street, Newark, NJ 07103, USA.
Rajaraman
V
V
Hunt
C D
CD
D000328:Adult; D017541:Aneurysm, False / Q000209:etiology / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000209:etiology; D002941:Circle of Willis / Q000293:injuries; D004724:Endoscopy / Q000009:adverse effects; D005005:Ethmoid Sinus / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D002532:Intracranial Aneurysm / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D009298:Nasal Polyps / Q000601:surgery; D019635:Neurosurgical Procedures; D010254:Paranasal Sinus Diseases / Q000601:surgery; D011183:Postoperative Complications; D012852:Sinusitis / Q000601:surgery; D019291:Skull Base / Q000601:surgery*; D013345:Subarachnoid Hemorrhage / Q000209:etiology; D020096:Zygomycosis / Q000601:surgery