CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2018; 37(02): 154-156
DOI: 10.1055/s-0038-1661357
Technical Note | Nota Técnica
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Surgery of a Posterior Communicating Artery Aneurysm with Fetal-Type Circulation

Cirurgia de um aneurisma da artéria comunicante posterior com circulação do tipo fetal
Nicolás González
1   Department of Neurosurgery, Hospital Regional Rancagua, Rancagua, Chile
,
Manuel Morales
1   Department of Neurosurgery, Hospital Regional Rancagua, Rancagua, Chile
,
Franco Ravera
1   Department of Neurosurgery, Hospital Regional Rancagua, Rancagua, Chile
,
Arturo Ruiz-aburto
1   Department of Neurosurgery, Hospital Regional Rancagua, Rancagua, Chile
,
Juan Vásquez
1   Department of Neurosurgery, Hospital Regional Rancagua, Rancagua, Chile
,
José Muller
1   Department of Neurosurgery, Hospital Regional Rancagua, Rancagua, Chile
,
Jhon Mosquera
1   Department of Neurosurgery, Hospital Regional Rancagua, Rancagua, Chile
,
Rodrigo Zapata
1   Department of Neurosurgery, Hospital Regional Rancagua, Rancagua, Chile
› Institutsangaben
Weitere Informationen

Publikationsverlauf

23. März 2018

08. Mai 2018

Publikationsdatum:
09. Juli 2018 (online)

Abstract

Inadvertent occlusion of a fetal-type posterior communicating artery in aneurysm surgery could result in posterior circulation infarction and neurological morbidity. The case of a patient with an unruptured posterior communicating artery aneurysm with lateral projection and a fetal-type posterior communicating artery is presented. The utility of the carotid-oculomotor window as a surgical corridor to safely find the fetal-type posterior communicating artery is discussed.

Resumo

A oclusão da artéria comunicante posterior do tipo fetal em cirurgia de aneurisma pode resultar em infarto da circulação posterior e morbidade neurológica. Apresentamos o caso de um paciente com aneurisma não roto da artéria comunicante posterior com projeção lateral e uma artéria comunicante posterior do tipo fetal. Discutimos a utilidade da janela carótida-oculomotora como um corredor cirúrgico para encontrar com segurança a artéria comunicante posterior do tipo fetal.

 
  • References

  • 1 Beumer D, Delwel EJ, Kleinrensink GJ, Akouri S, Torres A, Krisht AF. The perforator-free zone of the posterior communicating artery and its relevance in approaches to the interpeduncular cistern, especially the transcavernous approach: an anatomic study. Neurosurgery 2007; 61 (05) (Suppl. 02) 187-191 , discussion 191–192
  • 2 Golshani K, Ferrell A, Zomorodi A, Smith TP, Britz GW. A review of the management of posterior communicating artery aneurysms in the modern era. Surg Neurol Int 2010; 1: 88
  • 3 Thiarawat P, Jahromi BR, Kozyrev DA. , et al. Microneurosurgical Management of Posterior Communicating Artery Aneurysm: A Contemporary Series from Helsinki. World Neurosurg 2017; 101: 379-388
  • 4 Martins C, Yasuda A, Campero A, Rhoton Jr AL. Microsurgical anatomy of the oculomotor cistern. Neurosurgery 2006; 58 (04) (Suppl. 02) ONS-220-ONS-227 , discussion ONS-227–ONS-228
  • 5 González-Darder JM, Quilis-Quesada V, Talamantes-Escribá F, Botella-Maciá L, Verdú-López F. Microsurgical Relations between Internal Carotid Artery-Posterior Communicating Artery (ICA-PComA) Segment Aneurysms and Skull Base: An Anatomoclinical Study. J Neurol Surg B Skull Base 2012; 73 (05) 337-341
  • 6 Youssef AS, Abdel Aziz KM, Kim EY, Keller JT, Zuccarello M, van Loveren HR. The carotid-oculomotor window in exposure of upper basilar artery aneurysms: a cadaveric morphometric study. Neurosurgery 2004; 54 (05) 1181-1187 , discussion 1187–1189
  • 7 Kim YD, Elhadi AM, Mendes GA. , et al. Quantitative study of the opticocarotid and carotid-oculomotor windows for the interpeduncular fossa, before and after internal carotid artery mobilization and posterior communicating division. Neurosurgery 2015; 11 (Suppl. 02) 162-179 , discussion 179–180
  • 8 Kapsalaki EZ, Lee GP, Robinson III JS, Grigorian AA, Fountas KN. The role of intraoperative micro-Doppler ultrasound in verifying proper clip placement in intracranial aneurysm surgery. J Clin Neurosci 2008; 15 (02) 153-157
  • 9 Sharma M, Ambekar S, Ahmed O. , et al. The utility and limitations of intraoperative near-infrared indocyanine green videoangiography in aneurysm surgery. World Neurosurg 2014; 82 (05) e607-e613
  • 10 Güresir E, Schuss P, Seifert V, Vatter H. Oculomotor nerve palsy by posterior communicating artery aneurysms: influence of surgical strategy on recovery. J Neurosurg 2012; 117 (05) 904-910
  • 11 Anan M, Nagai Y, Fudaba H. , et al. Third nerve palsy caused by compression of the posterior communicating artery aneurysm does not depend on the size of the aneurysm, but on the distance between the ICA and the anterior-posterior clinoid process. Clin Neurol Neurosurg 2014; 123: 169-173
  • 12 Park SK, Shin YS, Lim YC, Chung J. Preoperative predictive value of the necessity for anterior clinoidectomy in posterior communicating artery aneurysm clipping. Neurosurgery 2009; 65 (02) 281-285 , discussion 285–286
  • 13 Sade B, Kweon CY, Evans JJ, Lee JH. Enhanced exposure of carotico-oculomotor triangle following extradural anterior clinoidectomy: a comparative anatomical study. Skull Base 2005; 15 (03) 157-161 , discussion 161–162
  • 14 Kim JH, Kim JM, Cheong JH, Bak KH, Kim CH. Simple anterior petroclinoid fold resection in the treatment of low-lying internal carotid-posterior communicating artery aneurysms. Surg Neurol 2009; 72 (02) 142-145