Two surgical cases of internal carotid-ophthalmic artery aneurysms: special reference to the usefulness of three-dimensional CT angiography.
Three-dimensional computerized tomography angiography (3D-CTA) is a noninvasive tool for the diagnosis of cerebral aneurysms. 3D-CTA is helpful in the evaluation of the configuration of aneurysms and their surrounding vessels and anatomical structures. The aim of this study is to assess the usefulness of 3D-CTA for patients with unruptured internal carotid-ophthalmic artery aneurysms. We pre-operatively obtained surgical simulation images using 3D-CTA and 3D reconstruction and then compared them with magnetic resonance angiography (MRA), conventional cerebral angiography and operative findings in the patients. Two patients with unruptured internal carotid-ophthalmic artery aneurysm were selected. These patients underwent direct neck clipping after the optic canal was unroofed through a combined epidural-subdural approach. The cerebral aneurysm was detected by 3D-CTA, MRA and conventional cerebral angiography in each case. Only by 3D-CTA, however, could we easily detect the relationships among the aneurysm neck, ophthalmic artery and optic canal. Based on this information, direct clipping operations were performed safely without any complications. 3D-CTA is an excellent noninvasive diagnostic method not only for detecting cerebral aneurysms, but also for evaluating the relationships between the aneurysms and surrounding structures.
Kawashima
Masatou
M
Department of Neurosurgery, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, 60 Fukuoka, 812-8582, Japan.
Matsushima
Toshio
T
Miyazono
Masayuki
M
Hirokawa
Eiko
E
Baba
Hitoshi
H
D000368:Aged; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D020215:Carotid Artery, Internal, Dissection / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002533:Cerebral Angiography; D035262:Cranial Fossa, Anterior / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D009915:Orbit / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures