Contralateral pterional approach to a giant internal carotid-ophthalmic artery aneruysm: technical case report.

Abstract:

OBJECTIVE AND IMPORTANCE:The contralateral approach to internal carotid-ophthalmic artery aneurysms has been used in selected cases but has rarely been described for a giant internal carotid artery aneurysm. We report a case of giant aneurysm that was successfully clipped via the contralateral pterional approach. CLINICAL PRESENTATION:A 69-year-old woman was found to have two aneurysms: a small aneurysm at the left internal carotid-posterior communicating artery and a giant aneurysm at the right internal carotid-ophthalmic artery. INTERVENTION:A direct clipping operation was performed via the left pterional approach. After the small left internal carotid artery aneurysm was clipped, the contralateral giant aneurysm was further exposed and successfully clipped by use of the same approach via the prechiasmatic space. CONCLUSION:The contralateral pterional approach can be applied even for a giant aneurysm of the carotid-ophthalmic artery aneurysm when the neck of the aneurysm is small and when there is a space between the anterior wall of the aneurysm and the tuberculum sellae. Furthermore, such a giant aneurysm can be clipped more easily and safely via the contralateral approach without compromising visual functions. To our knowledge, this is the first reported case of a giant internal carotid-ophthalmic artery aneurysm approached contralaterally. The feasibility of this approach can be assessed preoperatively by three-dimensional computed tomographic angiography as well as by conventional cerebral angiography.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Hongo K,Watanabe N,Matsushima N,Kobayashi S

doi

10.1097/00006123-200104000-00059

keywords:

subject

Has Abstract

pub_date

2001-04-01 00:00:00

pages

955-7; discussion 957-9

issue

4

eissn

0148-396X

issn

1524-4040

journal_volume

48

pub_type

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