Surgical management of aneurysms of the bifurcation of the internal carotid artery

Clinical Neurology and Neurosurgery
Nobuhiko MiyazawaKazuya Kanemaru

Abstract

Internal carotid artery (ICA) bifurcation aneurysms are rare and easily bleed in younger patients, but are difficult to treat surgically, due to perforators surrounding and adherent to the aneurysm. A series of 25 patients treated by clipping under the operating microscope are analyzed and compared with previous cases. Twenty-five patients, 11 men and 14 women (mean age 51 years), were treated by the same neurosurgeon. Seventeen patients presented with subarachnoid hemorrhage (Hunt & Kosnik Grade I in three, II in five, III in two, IV in seven), five with unruptured ICA bifurcation aneurysms, and three with unruptured ICA bifurcation aneurysms but another ruptured aneurysm. There were 23 small, one large, and one giant ICA bifurcation aneurysms. The projection was superior in 12, anterior in seven, and posterior in six cases. Pterional approach was employed for all cases. Outcomes were evaluated at discharge with the Glasgow Outcome Scale. Favorable outcomes (good recovery (GR) and moderate disability (MD)) were obtained in ten of 17 patients with ruptured ICA bifurcation aneurysm. Favorable outcomes were significantly greater in Grades I and II (three in I, four in II) than in Grades III and IV (one in III, two in IV; P=0.0498...Continue Reading

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Citations

Jul 6, 2012·Journal of Neurointerventional Surgery·Hidenori OishiHajime Arai
Apr 26, 2007·Neurologia Medico-chirurgica·Sunil Kumar GuptaSuresh Naraian Mathuriya
Oct 13, 2009·Surgical Neurology·Brian L Alexander, Howard A Riina
Mar 24, 2009·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Timothy Ibrahim, Brian P Brophy
Mar 31, 2009·Surgical Neurology·Martin LeheckaJuha Hernesniemi
Dec 3, 2005·Acta neurochirurgica·S SakamotoK Kurisu

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