Clipping of the Anterior Communicating Artery Aneurysm without Sylvian Fissure Dissection

Yun, Ji; Kang, Sung Goo; Kim, Jong Moon

doi:10.3340/jkns.2007.42.5.388

Cited by 4 publications

(6 citation statements)

References 10 publications

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“…The most suitable approach should provide the needed surgical corridor and optimal manipulation without brain damage, with minimal retraction for final clipping of AComA aneurysms (18). When the approach is decided, direction, sizes and locations of the AComA aneurysms should be considered for surgical strategy (9,10). The non-dominant (right) side can be chosen to decrease the neurologic deficit because the surgeons are usually more experienced on this side and majority are right handed (6).…”

Section: Discussionmentioning

confidence: 99%

“…Based on Yasargil classification (8), the AIHA is preferred for group 1 which closely related with the interhemispheric fissure. PA is preferred for group 2, but this determination can change according to the surgeon's experience and orientation (7)(8)(9)19). The PA is the easier and conventional approach, therefore PA is preferred more than AIHA (20).…”

Section: Discussionmentioning

confidence: 99%

“…The lateral group: Pterional approach (PA), orbitozygomatic approach, orbitopterional approach. The anterior group: Anterior interhemispheric approach (AIHA), subfrontal approach (9,10).…”

Section: Introductionmentioning

confidence: 99%

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Microsurgical management in Anterior Communicating Artery Aneurysms: an anatomical investigation

KARADAG

2021

Journal of Basic and Clinical Health Sciences

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circulation (1-3). As indicated in many previous studies AcomA anatomy shows variability. Mean length of AComA is between 2-3 mm with an average diameter of 1.6 mm was reported (1-3). The most common location of the intracranial aneurysms is the ABSTRACT Purpose: The purpose of this study is to compare the pterional approach and the anterior interhemispheric approach for enabling a better surgical maneuverability. We describe the ideal the anatomic limitations of this surgery for anterior communicating artery aneurysms. Methods: Four formalin-fixed and silicone injected human heads were used for each approach. Möller 20-1000 microscope (Wedel, Germany) was used for dissection and all the photographs were obtained at a similar angle to the surgical microscope, with Canon EOS Rebel T5 Digital SLR Digital Camera with an EF 100mm f/2.8L Macro IS USM Lens and a Canon MR-14EX II Macro Ring Lite Flash (Canon Inc., Ohta-ku, Tokyo, Japan). Our dissection includes anterior interhemispheric and pterional approach with gyrus rectus resection and posterolateral orbitotomy. Results: Pterional approach was performed followed by the gyrus rectus resection and posterolateral orbitotomy. This area can be exposed by the 1x1 cm resection of the gyrus rectus. Subpial resection from posterior part of gyrus rectus is required. Posterolateral orbitotomy was performed and the orbital roof was removed. The anterior interhemispheric approach allows better visualization of the anterior and inferior surface of anterior communicating artery, A1-A2 junction and the optic nerve. Conclusions: We believe that the pterional approach combined with gyrus rectus resection and posterolateral orbitotomy is more suitable for anterior, posterior and inferior type anterior communicating artery aneurysms. Also, anterior interhemispheric approach can be considered as safer route for superior and high positioned type.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Microsurgical management in Anterior Communicating Artery Aneurysms: an anatomical investigation

KARADAG

2021

Journal of Basic and Clinical Health Sciences

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“…Following surgery, AcomA aneurysm patients showed a reduced response to repetition tasks, and statistically significant differences were detected in repetition performance between the results of the two assessments in this group. Initially, this specific task had no relation with the AcomA area, yet surgical access may determine an inability to repeat, as it is made through the Sylvian fissure 12,19 , which is closely related to language. In the survey by Mavaddat et al 8 , patients who were submitted to surgery to block an AcomA aneurysm had cognitive disorders compatible with a temporal lobe dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…In most neurosurgical centers, treatment is anticipated in order to avoid further bleeding 12 . Nonetheless, the reality of developing countries' health systems does not permit further anticipation in surgery for aneurismal SAH patients.…”

mentioning

confidence: 99%

Performance of language tasks in patients with ruptured aneurysm of the left hemisphere worses in the post-surgical evaluation

Vieira

Andrade

Souza

et al. 2016

Arq. Neuro-Psiquiatr.

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Sub-arachnoid hemorrhage (SAH) promotes impairment of upper cortical functions. However, few information is available emphasizing changes in language after aneurismal SAH and aneurysm location influence. Objective To assess the language and verbal fluency performance in aneurismal SAH pre- and post-surgery in patients caused by an aneurysm of the anterior communicating artery (AcomA), left middle cerebral artery (L-MCA) and left posterior comunicating artery (L-PcomA). Methods Assessment in 79 patients with SAH, on two occasions: pre- and post surgical treatment. They were divided into three groups by the aneurysms’ location. Results Deterioration is detected in the performance of all patients during the post-surgical period; L-MCA aneurysm patients displayed a reduction in verbal naming and fluency; L-PcomA patients deteriorated in the written language and fluency tasks. Conclusion After the surgical procedure the patients decreased in various language tasks and these differences in performance being directly related to the location of the aneurysm.

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Outcomes for a case series of unruptured anterior communicating artery aneurysm surgery

Lai

Gragnaniello

Morgan

2013

Journal of Clinical Neuroscience

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Clipping of the Anterior Communicating Artery Aneurysm without Sylvian Fissure Dissection

Cited by 4 publications

References 10 publications

Microsurgical management in Anterior Communicating Artery Aneurysms: an anatomical investigation

Microsurgical management in Anterior Communicating Artery Aneurysms: an anatomical investigation

Performance of language tasks in patients with ruptured aneurysm of the left hemisphere worses in the post-surgical evaluation

Outcomes for a case series of unruptured anterior communicating artery aneurysm surgery

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