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Journal of Neurosurgical Sciences 2000 September;44(3):133-6

language: English

Giant intracranial aneurysm of the anterior communicating artery treated by direct surgical approach. Case report

Brambilla Bas M., Guerra N., Valsania V., Boccardo M.

Department of Neurosurgery, S. Corona General Hospital, Pietra Ligure, Savona, Italy


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We ­report the sin­gu­lar ­case of an excep­tion­al­ly ­large ­giant com­mu­ni­cat­ing ­artery aneu­rysm suc­cess­ful­ly treat­ed ­with a ­direct sur­gi­cal ­approach. The clin­i­cal pres­en­ta­tion was a rel­a­tive­ly ­short his­to­ry of fron­tal head­ache. In the pre- and post­con­trast CT ­scans the ­lesion mim­icked an intra­cra­ni­al ­tumor. At sur­gery the intra­lu­mi­nal throm­bus was par­tial­ly ­removed ­with an ultra­son­ic sur­gi­cal aspi­ra­tor; the decom­pres­sion ­allowed the iso­la­tion and sub­se­quent tem­po­rary dip­ping of the ­tracts A1 and A2 of ­both the ante­ri­or cere­bral arter­ies. It was ­then pos­sible to com­plete the throm­bec­to­my and to dip the ­neck of the aneu­rysm. The ­report empha­siz­es the indis­pens­able ­role of MRI for the accu­rate diag­no­sis of ­giant intra­cra­ni­al aneu­rysms and the ­recent improve­ment of the sur­gi­cal ­results con­cern­ing ­this cat­e­go­ry of aneu­rysms (main­ly relat­ed to the ­present wid­er avail­abil­ity of tech­ni­cal sur­gi­cal instru­men­ta­tion).

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