Role of Carotid Ligation in the Management of Intracranial Carotid Aneurysms

Jg, Galbraith; Rm, Clark

doi:10.1093/neurosurgery/21.cn_suppl_1.171

Cited by 19 publications

(4 citation statements)

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“…They are frequently treated by either balloon occlusion of the parent vessel or by endosaccular packing with detachable coils (van der Schaaf et al ., 2002). Before the introduction of endovascular strategies, therapeutic options included ligation of the ICA and direct microsurgical exposure of the cavernous aneurysm (Galbraith and Clark, 1974; Dolenc, 1983). However, some types of intracranial ICA aneurysms might not be suitable for neurosurgical clipping or endovascular therapy.…”

Section: Introductionmentioning

confidence: 99%

Progressive visual loss due to a muslinoma – report of a case and review of the literature

Berger¹,

Hartmann

Wildemann³

2003

Euro J of Neurology

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Intracranial internal carotid artery (ICA) aneurysms are frequently treated either by microsurgical clipping of the aneurysm neck, by endovascular coiling of the aneurysm sac or by balloon occlusion of the parent vessel. For some broad-based aneurysms that may not be suitable for any of these options, microsurgical wrapping of the aneurysm wall with muslin or gauze rarely is applied. We report the case of a patient who suffered from a minor stroke because of arterio-arterial embolism from an intracranial ICA aneurysm. The aneurysm was treated by wrapping muslin material. After 12 months, he experienced progressive visual loss. Cranial magnetic resonance testing magnetic resonance tomography (MRT) revealed a granulomatous inflammation surrounding the site of the aneurysm and affecting optochiasmatic structures. A muslin-induced optic neuropathy is a rare but serious complication of a chronic inflammatory reaction in response to muslin or gauze used in intracranial aneurysm wrapping. If the foreign body inflammatory reaction to muslin or gauze leads to a mass formation, the term muslinoma or gauzoma is applied. Various treatment strategies include surgery, steroids and cyclophosphamide, but recovery of the vision is not predictable. As a consequence, muslin or cotton gauze should only be applied with great caution in neurovascular surgery.

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Section: Introductionmentioning

confidence: 99%

Progressive visual loss due to a muslinoma – report of a case and review of the literature

Berger¹,

Hartmann

Wildemann³

2003

Euro J of Neurology

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“…The surgical treatment of cavernous aneurysm is difficult because of the surrounding cavernous sinus and its close proximity to the four cranial nerves. The therapeutic options in the past included surgical ligation of the internal carotid artery and direct microsurgical exposure of the cavernous aneurysms 5,6 . In recent years, endovascular treatment strategies are replacing the surgical treatments because they are less invasive, less time consuming and having fewer complications 7 .…”

Section: Discussionmentioning

confidence: 99%

Management of a Direct Carotid Cavernous Fistula Caused by Rupture of a Cavernous Aneurysm Previously Embolized with Coils

2003

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The development of a high-flow carotid-cavernous fistula from the rupture of a large cavernous aneurysm successfully embolized by coils is rare. A 50-year-old male patient developed a high-flow carotid-cavernous fistula 48 hours after successful coiling of a large left cavernous aneurysm, presumably due to rupture of a focal dissection at or close to the neck of the aneurysm. He initially responded to daily self-compression of the left common carotid artery, but the fistula recurred. After failing to approach the fistula site via transvenous route, balloon trapping of the internal carotid artery was planned. Prior to its placement for functional occlusion test, the detachable balloon slipped into the fistula site and occluded it. It was thereafter detached in this position. The sequence of events, a large cavernous aneurysm spontaneous ruptured after coiling, suggested dissecting process or disease. We address in the report the complexity of the endovascular management of this rare association.

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“…This report indicates the usefulness of the ultrasonic Doppler flowmeter with sound-spectrograph as a nontraumatic, fast and easily repeatable means of examining hemodynamics in Some authors'-1S have stressed the usefulness of monitoring ipsilateral retinal artery pressures during the daily closure of the clamp as the only way presently available to maintain control over the distal pressure changes. The combined use of nontraumatic techniques -Doppler flowmeter, including Doppler imaging apparatus, 7 ophthalmodynamometer and rCBF study by the xenon inhalation technique 13 will help facilitate safe gradual carotid occlusion.…”

Section: Discussionmentioning

confidence: 99%