Operative open intra-aneurysmal thrombectomy for ruptured cerebral aneurysm and peripheral ischemia associated with vasospasm.
The endovascular approach has become the standard treatment for ruptured aneurysms during the vasospasm risk period following subarachnoid hemorrhage; however, it may be disadvantageous under certain conditions. We report a patient with a ruptured middle cerebral artery aneurysm with severe vasospasm and thrombosis within the aneurysm immediately after angiography. Emergent operative open thrombectomy of the intra-aneurysmal thrombus restored blood flow to the ischemic penumbra territory demonstrated by single photon emission CT scan and diffusion-weighted MRI.
Harada
Kei
K
Department of Neurosurgery, Yamaguchi University Hospital, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. keiharakeihara@yahoo.co.jp
Kurokawa
Tetsu
T
Kato
Shoichi
S
Ishihara
Hideyuki
H
Saka
Makoto
M
Oka
Fumiaki
F
Fujisawa
Hirosuke
H
Fujii
Masami
M
Suzuki
Michiyasu
M
D017542:Aneurysm, Ruptured / Q000150:complications / Q000473:pathology / Q000601:surgery*; D002545:Brain Ischemia / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D017131:Thrombectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D020301:Vasospasm, Intracranial / Q000209:etiology / Q000473:pathology / Q000601:surgery*