Obliteration of Midline Vertebral Artery Aneurysm Via Basilar Craniectomy
1967; American Association of Neurological Surgeons; Volume: 26; Issue: 4 Linguagem: Inglês
10.3171/jns.1967.26.4.0406
ISSN1933-0693
Autores Tópico(s)Neurosurgical Procedures and Complications
ResumoOGUE TM and others have emphasized the difficulties and hazards of a surgical approach to certain aneurysms of the upper vertebral and basilar regions. We are reporting what we believe to be the first successful a t tempt at ligation of an intracranial aneurysm of the vertebral artery by the anterior transclival approach. Early in the 19th century, Cruveilhier 3 first described and illustrated an aneurysm of the vertebrobasilar circulation. Krayenbiih113 was the first to demonstrate a vertebrobasilar aneurysm by positive contrast arteriography, using a retrograde subclavian injection technique. Dandy 4 discussed his experience with the surgical treatment of three vertebrobasilar aneurysms. Schwartz 2s is credited with the first case of a posterior fossa aneurysm diagnosed prior to surgery and successfully attacked by a direct surgical approach through the standard suboccipital craniectomy. Since then many patients have been operated upon for vertebrobasilar aneurysm and the results have been variable. l ' 5 -1 1 ' lT ' l s ' 20 ' 22 -25 ' 27 ,29 ' a l ' 34 Methods have included ligation of the neck of the aneurysm with or without excision of the aneurysm, trapping by ligation of efferent and afferent arteries supplying the aneurysm, reinforcement of the aneurysmal wall, or ligation of the proximal vertebral artery in its intracranial or extracranial position. Only suboccipital and subtemporal approaches have been used. Since the development of the anterior approach for cervical discs there has been increased interest in attacking higher lesions through the anterior approach. Mullah, et al., 21 did a subtotal removal of neoplasm anterior to the brain stem and upper cervical spinal cord by incising the posterior nasopharyngeal wall through the mouth. Stevenson, et al., 3e described a transclival approach
Referência(s)