Multiple Paraclinoid Aneurysms and Basilar Tip Clipped by the Same Orbito-Zygomatic Approach: 2-Dimensional Operative Video.

IF 1.9 4区 医学 Q3 CLINICAL NEUROLOGY World neurosurgery Pub Date : 2024-12-05 DOI:10.1016/j.wneu.2024.11.020
Rabindranath Garcia-Lopez, Josue A Cervantes-Gonzalez, Eli Hernandez-Chavez, Maria J Arevalo-Torres, Victor Ramzes Chavez-Herrera
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Abstract

The management of multiple intracranial aneurysms poses a significant clinical challenge.1 Various factors, including the patient's neurologic status, age, risk factors, aneurysm morphology, location, ruptured or unruptured status, availability of equipment, the surgeon's surgical abilities, and patient preferences, influence the choice of treatment modality.2 It has been observed that there is a higher risk of rupture during the perioperative period when surgical intervention is performed to treat a ruptured aneurysm.3 Additionally, it is suggested that patients with multiple aneurysms located in both the anterior and posterior circulation are less likely to be treated with a single procedure.4 This surgical strategy should be applied in the setting of multiple aneurysms in the anterior and posterior circulation that would, on the other hand, demand multiple interventions.5 In an experienced scenario, microsurgery could be a viable option. We present the case of a 58-year-old patient who presented with chronic headaches, a medical history of hypertension, and tobacco use. The patient had no neurologic deficits. During imaging, 5 incidental aneurysms were found. Bilateral ophthalmic aneurysms, one ipsilateral ventral paraclinoid aneurysm, at the bifurcation of the internal carotid artery, and another at the top of the basilar. The aneurysms were clipped with an orbito-zygomatic approach, and the patient had no postoperative neurologic deficit (Video 1). The patient consented to the procedure and publication of her image. No institutional research ethics board approval was required because only intraoperative footage was shown. No identifiable data are displayed except for 2 photographs of the patient's head without the face, which was appropriately consented to.

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采用同一眼眶-颧骨入路夹闭多发性腮旁动脉瘤和基底动脉尖:二维手术视频。
治疗多发性颅内动脉瘤是一项重大的临床挑战。1 各种因素,包括患者的神经状况、年龄、风险因素、动脉瘤形态、位置、破裂或未破裂状态、设备的可用性、外科医生的手术能力以及患者的偏好,都会影响治疗方式的选择。2 据观察,在围手术期进行手术治疗破裂的动脉瘤时,破裂的风险较高。3 此外,有研究表明,位于前循环和后循环的多发性动脉瘤患者不太可能只接受一次手术治疗。4 这种手术策略应适用于前后循环均有多个动脉瘤的情况,因为这种情况需要进行多次干预。5 在经验丰富的情况下,显微外科手术可能是一个可行的选择。我们接诊了一位 58 岁的患者,他有慢性头痛、高血压病史和吸烟史。患者无神经功能障碍。在造影过程中,发现了五个偶发性动脉瘤。双侧眼动脉瘤,一个同侧腹侧蛛网膜旁动脉瘤,位于颈内动脉分叉处,另一个位于基底动脉顶部。动脉瘤通过眶颧入路被剪除,术后患者没有出现神经功能障碍。患者同意该手术并同意公布其图像。机构审查委员会说明:由于只显示术中片段,因此无需获得机构研究伦理委员会的批准。除了两张不含面部的患者头部照片外,未显示任何可识别的数据,这一点已得到患者的适当同意。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
World neurosurgery
World neurosurgery CLINICAL NEUROLOGY-SURGERY
CiteScore
3.90
自引率
15.00%
发文量
1765
审稿时长
47 days
期刊介绍: World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
期刊最新文献
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