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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(02): 363-369
DOI: 10.4103/ajns.AJNS_39_20
Original Article

Visual outcomes after surgery for paraclinoid aneurysms: A fujita experience

Raja Kutty
Department of Neurosurgery, Government Medical College, Trivandrum, Kerala
,
Ambuj Kumar
1   Department of Neurosurgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh
,
Yasuhiro Yamada
2   Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Otobashi, Nagoya
,
Tsukosa Kawase
2   Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Otobashi, Nagoya
,
Riki Tanaka
2   Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Otobashi, Nagoya
,
Kyosuke Miyatani
3   Department of Neurosurgery, Banbuntane Hotokukai Hospital, Otobashi, Nagoya
,
Saeko Higashiguchi
3   Department of Neurosurgery, Banbuntane Hotokukai Hospital, Otobashi, Nagoya
,
Vigneswar Ravishankar
4   Department of Neurosurgery, Institute of Neurosciences and Spinal Disorders, MGM Healthcare, Chennai, Tamil Nadu
,
Katsumi Takizawa
5   Department of Neurosurgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Hokkaido
,
Yoko Kato
3   Department of Neurosurgery, Banbuntane Hotokukai Hospital, Otobashi, Nagoya
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Introduction: The surgical strategies for clipping of paraclinoid aneurysms are diverse. These aneurysms are unique in their location, as they closely abut the anterior clinoid process (ACP) and the optic nerve. The ultimate goal of clipping encompasses the exposure of neck of the aneurysm which is seldom complete without the manipulation of optic nerve and the ACP. This manipulation may result in disturbances of vision postoperatively. We analyze our results of visual outcomes in the surgery for paraclinoid aneurysms in this retrospective study. Materials and Methods: All patients with paraclinoid aneurysms who underwent surgery from June 2014 to June 2019 were included in the study. Surgical procedure was uniform in all patients which included anterior clinoidectomy and clipping of aneurysms as per the Bantane protocol. Glasgow Outcome Scale as well as vision was assessed at discharge and at 1 month and 6 months. Results: There were 77 cases of paraclinoid aneurysms operated during the abovementioned period. All patients had no symptoms related to vision preoperatively. Visual deterioration was noted in two patients. All patients were discharged with a good outcome on the Glasgow Outcome Scale. Conclusion: Paraclinoid aneurysm has a good outcome when treated with surgery. The visual deterioration following surgery can be minimized with extradural anterior clinoidectomy and careful handling of the vessels and nerve.

Key-words:

Clipping - paraclinoid aneurysms - visual outcomes

Financial support and sponsorship

Nil.




Publication History

Received: 03 February 2020

Accepted: 25 February 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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