title: Indocyanine green videoangiography for vessel identification and preservation prior to dural opening for microvascular decompression.
abstract: Unexpected bleeding from the dural sinus can sometimes occur when performing a dural opening during microvascular decompression. We conducted dural opening safely by performing indocyanine green (ICG) videoangiography before making a dural incision. We introduce two specific cases in which surgery was performed to treat a trigeminal neuralgia. In both cases, a small craniectomy was performed in the transverse-sigmoid junction. ICG (0.25 mg/kg dose) was administered intravenously just prior to dural opening. Using a microscope equipped with fluorescent filters, real-time flow assessment of the underlying veins was done. ICG videoangiography allowed for a clear confirmation of the margins of the dural sinus as well as the vascular structures at the surface of the cerebellum, which were clearly seen through the dura mater. Performing ICG videoangiography prior to dural opening makes it possible to safely perform dural opening.
authors: Takeda General Hospital, Department of Neurosurgery, Fushimi, Kyoto, Japan.
authors: Kunio
authors: K
authors: Yokoyama
authors: Masahiro
authors: M
authors: Kawanishi
authors: Makoto
authors: M
authors: Yamada
authors: Hidekazu
authors: H
authors: Tanaka
authors: Yutaka
authors: Y
authors: Ito
authors: Toshihiko
authors: T
authors: Kuroiwa
mesh_terms: D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D004396:Coloring Agents / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D004388:Dura Mater / Q000098:blood supply / Q000601:surgery*; D005260:Female; D006801:Humans; D007208:Indocyanine Green / Q000008:administration & dosage*; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D014277:Trigeminal Neuralgia / Q000601:surgery*; D014741:Video Recording
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green