[Microsurgical treatment of internal carotid bifurcation aneurysms].
Clinical and imaging findings of a series of 14 internal carotid artery bifurcation aneurysms microsurgically treated are presented. A total of 10 lesions were diagnosed before rupture and 4 patients presented with subarachnoidal hemorrhage and frontobasal intracerebral bleeding. Diagnosis was done using neuroimaging (CT scan, angio-CT-3D, angio-MRI, angiography) but patients with ruptured aneurysms were treated with the sole information provided by the angio-CT-3D. The average fundus size was 8.4mm (3-13.3) and the average neck size was 6.8mm (3-9.6), being the fundus-to-neck ratio 1.32 (0.46-2.05). All lesions were microsurgically treated through a pterional approach with the help of temporary clipping of the afferent vessels in all cases. We used peroperative neuroprotective, neuromonitorization and micro-doppler cerebral flow measurement. Clinical results were excellent with 13 patients GOS grade 5 and one grade 4 three month afterwards of hospital discharge and complete exclusion of the lesion in angiographic controls done solely in patients with ruptured lesions.
González-Darder
J M
JM
Servicio de Neurocirugía, Hospital Clínico Universitario de Valencia, Servicio Valenciano de Salud.
González-López
P
P
Botella-Maciá
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D002343:Carotid Artery, Internal / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial; D055815:Young Adult