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middle_cerebral_artery_aneurysm_surgery

Middle cerebral artery aneurysm surgery

Indications

Microsurgical clipping may receive increased consideration in patients presenting with large (>50 ml) intraparenchymal hematomas and middle cerebral artery aneurysms 1).

Craniotomy for hematoma evacuation and aneurysm clipping is the treatment modality of choice for ruptured middle cerebral artery (MCA) aneurysms with intracranial hematomas. Recent literature suggests that endovascular coil embolization followed by hematoma evacuation can be an acceptable alternative.

MCA aneurysm rupture with concomitant large intraparenchymal or sylvian fissure hematoma formation carries a grave prognosis. Simultaneous hematoma evacuation and aneurysm clipping with or without craniectomy can be an effective treatment modality 2).

Approaches

see Middle cerebral artery aneurysm surgery approaches.

1)
Connolly ES, Jr, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, Hoh BL, Kirk- ness CJ, Naidech AM, Ogilvy CS, Patel AB, Thompson BG, Vespa P, American Heart Associa- tion Stroke Council, Council on Cardiovascular Radiology, Intervention, Council on Cardiovas- cular Nursing, Council on Cardiovascular Sur- gery, Anesthesia, Council on Clinical Cardiology. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/american Stroke Association. Stroke. 2012; 43:1711–1737
2)
Stapleton CJ, Walcott BP, Fusco MR, Butler WE, Thomas AJ, Ogilvy CS. Surgical management of ruptured middle cerebral artery aneurysms with large intraparenchymal or sylvian fissure hematomas. Neurosurgery. 2015 Mar;76(3):258-64. doi: 10.1227/NEU.0000000000000596. PubMed PMID: 25603109.
middle_cerebral_artery_aneurysm_surgery.txt · Last modified: 2019/04/24 19:07 by administrador