title: Ruptured anterior paraclinoid aneurysms.
abstract: The purpose of this study was to evaluate cases of subarachnoid hemorrhage (SAH) from ruptured anterior (dorsal) paraclinoid aneurysms. Anterior paraclinoid aneurysms are defined as aneurysms arising from the anterolateral wall of the proximal internal carotid artery without any relationship to an arterial branch. Between 1991 and 2008, a total of 159 patients with 169 paraclinoid aneurysms were treated at the Shinshu University Hospital and its affiliated hospitals. A retrospective analysis was carried out using charts, operation records, operation videos, and neuroimagings. Twenty six patients had anterior paraclinoid aneurysm. Six patients presented with SAH. Three aneurysms were saccular and the others were blister-like aneurysms based on operative findings. Neck laceration or premature rupture frequently happened during the clipping surgery even though the aneurysm was saccular type. The treatment of a ruptured anterior paraclinoid aneurysm is quite difficult. Trapping and bypass would be recommended for such fragile aneurysms.
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan. tetuyosi@shinshu-u.ac.jp
authors.forename: Tetsuyoshi
authors.initials: T
authors.lastname: Horiuchi
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kusano
authors.forename: Takehiro
authors.initials: T
authors.lastname: Yako
authors.forename: Takahiro
authors.initials: T
authors.lastname: Murata
authors.forename: Yukinari
authors.initials: Y
authors.lastname: Kakizawa
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hongo
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000473:pathology*; D002342:Carotid Artery, External / Q000473:pathology*; D002533:Cerebral Angiography; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging; D013346:Subarachnoid Space / Q000473:pathology; D014057:Tomography, X-Ray Computed