Document Detail

Plical resection in pre-temporal approach for basilar bifurcation aneurysms: preliminary surgical experience and cadaveric study.
MedLine Citation:
PMID:  18633571     Owner:  NLM     Status:  MEDLINE    
OBJECT: Although a pre-temporal approach (PA) can provide a wide space for preservation of thalamoperforating atrteries in direct surgery for basilar bifurcation aneurysms (BBAs), it cannot always secure adequate proximal control. The authors described the advantages of plical resection added to PA for BBAs. METHODS: Between October 1998 and April 2000, eight consecutive patients with BBAs were treated in the neurosurgical department of Kurashiki Central Hospital. Among them, five patients received direct clipping using this method. There were four females and one male, ages ranging from 61 to 77 (mean 70.8 years). Mean aneurysmal size and distance between the in"terclinoidal line and the aneurysmal neck was 4.5 and 9.5 mm, respectively. The operative procedures consisted of the following components; 1) fronto-temporal craniotomy with translocation of orbito-zygomatico-malar bone for PA, 2) preservation of lateral branches of the superficial sylvian veins, 3) resection of plica dural folds to increase the operative field up to the oculomotor nerve (OMN). RESULTS: Complete clipping was achieved without thalamic infarction or temporal contusion in all patients. Three of the five patients suffered from transient right OMN palsy which recovered within two months after surgery. CONCLUSION: Plical resection in the pre-temporal approach might be beneficial in the surgical treatment of BBAs when proximal control seems difficult.
K-I Kikuta; S Yamagata; Y Arakawa; M Hojo; A Ishii; K Nozaki; N Hashimoto
Publication Detail:
Type:  Journal Article     Date:  2008-07-17
Journal Detail:
Title:  Acta neurochirurgica     Volume:  150     ISSN:  0942-0940     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-24     Completed Date:  2008-09-25     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  749-56; discussion 756     Citation Subset:  IM    
Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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MeSH Terms
Basilar Artery / surgery*
Craniotomy / methods*
Dura Mater / surgery
Frontal Bone / surgery
Intracranial Aneurysm / surgery*
Middle Aged
Neurosurgical Procedures / methods*
Ophthalmoplegia / etiology
Postoperative Complications / etiology
Skull Base / surgery
Temporal Bone / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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