Document Detail

Incidence of superficial sylvian vein compromise and postoperative effects on CT imaging after surgical clipping of middle cerebral artery aneurysms.
MedLine Citation:
PMID:  16155152     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Dissection and retraction of the sylvian fissure can cause venous insufficiency and may be an important contributor to postoperative edema or hemorrhage after clipping of a middle cerebral artery (MCA) aneurysm. The incidence of changes in the superficial middle cerebral vein (SMCV) and adjacent veins and whether such changes increase the amount of edema or hemorrhage on postoperative CT is the focus of this study. METHODS: Pre- and postoperative angiograms of 100 consecutive patients with MCA aneurysms treated by craniotomy and clipping were compared to determine the postoperative incidence of changes involving the SMCV. CTs from the normal and abnormal postoperative venous groups were compared to determine the amount of edema or presence of parenchymal hemorrhage. RESULTS: Postoperatively, 31 (31%) SMCVs were altered, 20 to a minor or moderate degree. Eleven cases were pronounced. In 9 (9%) cases, the SMCV was completely obscured or failed to fill on postoperative angiography. More edema (observer 1, P < .0002; observer 2, P < .0006) and small brain parenchymal hemorrhages (observer 1, P < .00003; observer 2, P < .00001) were found on the postoperative CT images of the group whose SMCVs were altered than those that were unchanged. CONCLUSIONS: Neurosurgeons and neuroradiologists should be attentive to changes in the SMCV and adjacent venous structures to optimize outcomes of procedures involving the sylvian fissure.
Bruce L Dean; Robert C Wallace; Joseph M Zabramski; Alan M Pitt; C Roger Bird; Robert F Spetzler
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  26     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-09-12     Completed Date:  2005-12-02     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2019-26     Citation Subset:  IM    
Division of Neuroradiology, Barron Neurological Institute, Phoenix, AZ 85013, USA.
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MeSH Terms
Brain Edema / etiology,  radiography
Cerebral Angiography
Cerebral Hemorrhage / etiology,  radiography
Cerebral Veins / physiopathology*,  radiography*
Intracranial Aneurysm / radiography,  surgery*
Neurosurgical Procedures / adverse effects*
Tomography, X-Ray Computed*

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