Microsurgical anatomy of the arteries of the pituitary stalk and gland as viewed from above

Gibo, Hirohiko; Kobayashi, Sumio; Kyoshima, Kazuhiko; Hokama, Masanobu

doi:10.1007/bf01541268

Cited by 41 publications

(18 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This finding indicated that there was some collateral blood flow through the anastomosis; however, it was unclear whether the retrograde blood flow would be sufficient. In previous anatomical studies, 7,8,18 unilateral variation of the SHA has not been reported. If there is no circumferential anastomosis between the right and left SHAs in some patients, unilateral SHA occlusion must cause ischemia of the optic nerve and/or chiasm, resulting in postoperative visual disturbance.…”

Section: Sha and Visual Functionmentioning

confidence: 84%

“…Day 3 reported that SHA preservation should be attempted in all patients but that it is not always possible because this artery is small and easily obliterated by fenestrated clips. Because there are circumferential anastomoses of the SHA, 7,8,18 obliteration of the SHA will not cause visual disturbance. 2,3,15,21 Our study also showed that SHA sacrifice was not a factor for postoperative visual impairment.…”

Section: Sha and Visual Functionmentioning

confidence: 99%

See 1 more Smart Citation

Role of superior hypophyseal artery in visual function impairment after paraclinoid carotid artery aneurysm surgery

Horiuchi

Goto

Tanaka

et al. 2015

JNS

View full text Add to dashboard Cite

A ccording to the related branching artery or anatomical relationships, there are many classifications of intradural proximal carotid artery aneurysms. In the literature, the term "paraclinoid carotid aneurysm" is often used because it includes all carotid artery aneurysms originating from the internal carotid artery (ICA) between the distal dural ring and the origin of the posterior communicating artery. 11,12,21 The superior hypophyseal artery (SHA) is well known as a branching artery of paraclinoid carotid artery aneurysms 16,21,22 and supplies the pituitary stalk, optic nerve, and chiasm. 8,14,18 Therefore, sacrifice of the SHA may be a factor for postoperative visual impairment. 4,9,13 Although a few case reports have described postoperative visual impairment associated with SHA occlusion, 4,9,13 only small series of SHA aneurysm surgery cases have focused on postoperative visual function and intraoperative SHA status. We report our experience with 72 SHA aneurysms in 70 patients and our analysis of the postoperative visual function associated with the SHA. MethodsThis study was approved by the institutional review board at the Shinshu University School of Medicine. Patient PopulationBetween January 1991 and December 2013, a total of 181 patients harboring 190 paraclinoid carotid artery anabbreviatioNs ICA = internal carotid artery; SHA = superior hypophyseal artery; VEP = visual evoked potential. subMitted June 3, 2014. accePted December 29, 2014. iNclude wheN citiNg Published online February 20, 2015; DOI: 10.3171/2014.12.JNS141218. disclosure The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. This study was partly supported by the Japan Society for the Promotion of Science KAKENHI grant no. 25462251 (to T.H). obJect Although a number of studies have assessed the surgical treatment of paraclinoid-segment carotid artery aneurysms and resulting visual complications, less attention has been given to the results with respect to the superior hypophyseal artery (SHA). The authors evaluated the relationship between the aneurysm, the SHA itself, and postoperative visual function in patients with ruptured and unruptured SHA aneurysms. Methods From January 1991 through December 2013, 181 patients with 190 paraclinoid carotid artery aneurysms received treatment at Shinshu University Hospital and its affiliated hospitals. The authors retrospectively analyzed charts, operative records, operative videos, and neuroimaging findings for these patients with or without postoperative visual complications. results The authors identified 72 SHA aneurysms in 70 patients (mean age 58 years). Of 69 patients (1 patient died) evaluated, postoperative visual complications occurred in 9 (13.0%). Although the aneurysm size and SHA sacrifice did not lead to postoperative visual impairment, simultaneous treatment of bilateral aneurysms was a risk factor for postoperative visual complications. coNclusioNs Unilateral SHA impairment may be safe (i.e., i...

show abstract

Section: Sha and Visual Functionmentioning

confidence: 84%

Section: Sha and Visual Functionmentioning

confidence: 99%

Role of superior hypophyseal artery in visual function impairment after paraclinoid carotid artery aneurysm surgery

Horiuchi

Goto

Tanaka

et al. 2015

JNS

View full text Add to dashboard Cite

show abstract

“…The superior hypophyseal artery is thought to arise from the medial to the posterior aspect of the proximal intradural ICA, branch out to the optic nerve and chiasm, and then terminate in the pituitary stalk and gland [3,8]. In a previous report, the carotid cave aneurysm was found to arise close to the origin of' this artery in 3 of 7 surgical cases [10].…”

Section: Discussionmentioning

confidence: 96%

Micro-anatomical study of the carotid cave

et al. 1997

View full text Add to dashboard Cite

The surgical treatment of aneurysms located in the carotid cave is often hazardous and difficult. We studied the micro-anatomy of the carotid cave and its neighbourhood by microscopic observation and histological examination using 50 sides from 25 autopsy cases. The carotid caves were found in 34 out of the 50 sides (68%) examined and were usually located in the posteromedial aspect of the carotid dural ring. They were classified into three types according to the topographic micro-anatomy: the slit-type (17/50, 34%) which showed a small, thin recess of the dura mater with fine connective tissue loosely adhered to the carotid wall; the pocket-type (12/50, 24%) which had a definite dural pouch with the apex attached to the vessel wall; and the mesh-type (5/50, 10%) which formed a slit- or pocket-type dural cave covered with a mesh-like dural roof. The remaining 16 sides (32%) showed tight dural attachment without any caval structure around the dural ring. The posteromedial portion of the carotid dural ring had no contact with any bony structure, and this distinct anatomical feature thus appear to facilitate the formation of the carotid cave. Furthermore, the availability of this potential space and the closely situated origin of the superior hypophyseal artery as well as the haemodynamic effect of the internal carotid artery may allow the development of the carotid cave aneurysm.

show abstract

“…Their number varies, ranging from one to four arteries on each side (n ϭ 35) (mean 2.3 per side). Gibo et al (1988) reported up to five superior hypophyseal arteries per side.…”

Section: Extension To the Supradiaphragmatic Intradural Spacementioning

confidence: 99%