A combined approach to treatment of the dissecting middle cerebral artery fusiform aneurysm. A case report.
A fusiform aneurysm in the terminal M1 middle cerebral artery (MCA) segment was treated by a construction of a high-flow arterial extracranial-intracranial (EC-IC) bypass. Due to severe bypass vasospasms, local vasodilating agents together with percutaneous angioplasty and stent implantation were applied, but failed due to subsequent bypass occlusion. To remedy this complication a new bypass was created from a segment of the saphenous vein, followed by MCA aneurysm embolization and parent artery occlusion. One year after the surgery, the venous bypass remains patent and the aneurysm occluded, with the patient fully active, without any neurological sequelae.
Hrbác
T
T
Neurosurgery Clinic, University Hospital Ostrava; Poruba, Czech Republic - angio@vol.cz.
Drábek
P
P
Klement
P
P
Procházka
V
V
Neuroimaging Clin N Am. 2006 Aug;16(3):453-65, viii
16935710
Neurosurgery. 2007 May;60(5):E950-1; discussion E950-1
17460508
Neurosurgery. 2001 Sep;49(3):646-58; discussion 658-9
11523676
Arq Neuropsiquiatr. 2000 Mar;58(1):162-8
10770883
AJNR Am J Neuroradiol. 2008 Oct;29(9):1775-6
18583412
J Neurosurg Sci. 1999 Dec;43(4):237-50; discussion 250-1
10864386
J Neurosurg Sci. 2008 Mar;52(1):1-9; discussion 9-10
18427426
J Neurosurg. 2007 Jun;106(6 Suppl):495-500
17566409
AJNR Am J Neuroradiol. 2001 Oct;22(9):1704-10
11673165
Stroke. 2000 Apr;31(4):896-900
10753995