| Title: | [Therapeutic occlusion of unilateral vertebral artery for unclippable aneurysms; special reference to postoperative brainstem ischemia] |
| Author(s): | Yasui T; Yagura H; Komiyama M; Fu Y; Nagata Y; Tamura K; Kim A; |
| Address: | "Department of Neurosurgery, Baba Memorial Hospital" |
| ISSN/ISBN: | 0301-2603 (Print) 0301-2603 (Linking) |
| Abstract: | "Seven cases of unclippable vertebral artery aneurysms (3 dissecting, 1 fusiform, 2 saccular and 1 giant) are reported. Five of these had subarachnoid hemorrhage, one showed mass effect and the other was found incidentally. Trapping of the involved portion of the vertebral artery was performed in 4 cases, proximal clip occlusion in 2 and proximal balloon occlusion in 1. There were no operative deaths and no rebleeding, but brainstem ischemia developed in 4 cases, two being transient and two permanent. The ischemic complications were possibly due to; (a) hypoperfusion in the transient cases and (b) thromboenbolism, from the partially thrombosed giant aneurysm or thrombosis of the cul-de-sac vertebral artery, in the permanent ones. Preoperative temporary vertebral artery occlusion with an inflatable balloon or postoperative anticoagulant therapy should be considered in the management protocol" |
| Keywords: | Aortic Dissection/complications/surgery Brain Ischemia/*etiology Brain Stem/*blood supply Constriction Female Humans Intracranial Aneurysm/complications/*surgery Intracranial Embolism and Thrombosis/complications Male Middle Aged *Postoperative Complicati; |
| Notes: | "MedlineYasui, T Yagura, H Komiyama, M Fu, Y Nagata, Y Tamura, K Kim, A jpn Case Reports English Abstract Japan 1992/04/01 No Shinkei Geka. 1992 Apr; 20(4):325-32" |
