title: [Surgical management of paraclinoid aneurysms].
abstract: BACKGROUND
  Paraclinoid aneurysms arise from C5 clinoid segment and C6 ophthalmic segment, within the internal carotid artery. Brain aneurysms have a frequency ranging from 5 to 11 %. A successful surgery requires knowledge of the anatomic region and the aneurysm. The objective was to show the surgical management of paraclinoid aneurysms.
  
  
  METHODS
  From January 2009 to January 2015, we carried out a retrospective study in the Neurosurgery Department at Centro Médico Nacional Siglo XXI. We included 66 patients with the diagnosis of paraclinoid aneurysm. We obtained the clinical characteristics, evolution, complications, and outcomes from the clinical and radiological records.
  
  
  RESULTS
  61 patients (92.4 %) were female; 65 underwent neurosurgical clipping, and one underwent cerebral bypass surgery with exclusion of the aneurysm. Forty six patients presented subarachnoid hemorrhage due to aneurysmal rupture. By reason of their location, 35 paraclinoid aneurysms (53 %) were superior, 20 medial (30.3 %) and 4 inferior (6 %). Thirty three patients had small aneurysms, 23 large aneurysms, and 10 patients presented giant aneurysms. After surgery, 51 patients had good results, since they scored 4 and 5 in the Glasgow Outcome Score. Three patients presented amaurosis as a surgery-related complication.
  
  
  CONCLUSIONS
  Microsurgical management is still the best treatment for these aneurysms, due to its ability to exclude them entirely; besides, is the best method to decompress the optic nerve.
authors: Servicio de Neurocirugía, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México. eduardo.magallon@imss.gob.mx.
authors: Eduardo
authors: E
authors: Magallón-Barajas
authors: Miguel
authors: M
authors: Abdo-Toro
authors: Claudia
authors: C
authors: Flores-Robles
mesh_terms: D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*
keywords: Internal carotid artery; Intracraneal aneurysm; Optic nerve; Subarachnoid hemorrhage