脳動脈瘤clipping術におけるclip headによる穿通枝圧迫についての検討

鈴木 陽祐; 野田 公寿茂; 安田 宗一郎; 岡田 泰明; 千田 大樹; 安田 貴哉; 喜古 一成; 宮崎 貴則; 三好 教生; 近藤 智正; 原口 健一; 太田 仲郎; 徳田 禎久; 上山 博康; 谷川 緑野

doi:10.2335/scs.51.167

Case Reports

Review of Two Cases of Compression by the Perforator Branch of the Clip Head Causing an Ischemic Change

Yosuke SUZUKI, Kosumo NODA, Souichirou YASUDA, Yasuaki OKADA, Daiki CHIDA, Takaya YASUDA, Katsunari KIKO, Takanori MIYAZAKI, Norio MIYOSHI, Tomomasa KONDO, Kenichi HARAGUCHI, Nakao OTA, Sadahisa TOKUDA, Hiroyasu KAMIYAMA, Rokuya TANIKAWA

Author information

Yosuke SUZUKI
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital
Kosumo NODA
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital
Souichirou YASUDA
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital
Yasuaki OKADA
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital
Daiki CHIDA
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital
Takaya YASUDA
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital
Katsunari KIKO
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital
Takanori MIYAZAKI
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital
Norio MIYOSHI
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital
Tomomasa KONDO
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital
Kenichi HARAGUCHI
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital
Nakao OTA
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital
Sadahisa TOKUDA
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital
Hiroyasu KAMIYAMA
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital
Rokuya TANIKAWA
Stroke Center, Department of Neurosurgery, Sapporo Teishinkai Hospital

Keywords: the head of the surgical clip, postoperative perforator infarction, MEP monitoring, neurological examination after the surgery

JOURNAL FREE ACCESS

2023 Volume 51 Issue 2 Pages 167-172

DOI https://doi.org/10.2335/scs.51.167

Details

Abstract

We experienced two cases of surgical clipping of intracerebral unruptured aneurysms, in which compression of the penetrating branch by the clip head caused an ischemic change. Perforator branch compression by the clip head may occur after clipping of an aneurysm and it worsens the prognosis if left untreated. In Case 1, motor evoked potential (MEP) monitoring was effective during surgery, and in Case 2, the confirmation of neurological findings was helpful after surgery. Early detection and retreatment may improve prognosis, and based on this case, we will report on how to deal with this problem.

Corresponding author

Register with J-STAGE for free!