脳卒中の外科
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
内頸眼動脈動脈瘤の脳血管撮影所見から見たcombined extra- and intradural direct approachの選択
和田 啓二中川原 譲二佐々木 雄彦橋本 郁郎佐土根 朗鈴木 知毅奥村 智吉岡 亨治武田 利兵衛末松 克美中村 順一
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1991 年 19 巻 1 号 p. 99-102

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A series of 5 patients with a carotid-ophthalmic artery aneurysm were treated surgically. In two patients the aneurysms were large, and two had ruptured. The combined extra- and intradural direct approach seemed to provide a better and safer exposure of the central segment of the internal carotid artery. However, a finding of anterosuperior or superolateral direction of the aneurysm in cerebral angiography indicated danger of rupture of the aneurysm during extradural drilling. In this anatomical situation, intradural removal of the anterior clinoid process makes it safer to state in contact with the wall of aneurysm. In two of the five patients these aneurysms were clipped by removing the anterior clinoid process intradurally. The angiographical direction of the aneurysm dictates the selection of approach for removing the anterior clinoid process and unroofing the optic canal.
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