A Surgical Experience of the Distal Posterior Cerebral Artery Aneurysm

Advances in microneurosurgical treatment of arterial aneurysm have led to increased interest being focused on aneurysm situated within the posterior cerebral fossa. Despite this, reports of neurosurgical intervention in such cases are still rare and there is no report about the distal posterior cerebral artery aneurysm in Korea. An aneurysm of the posterior cerebral artery has been referred to as a "distinct rarity", making up about 0.26 to 2.7% of all cerebral aneurysms. Especially, the incidence of the distal posterior cerebral artery aneurysm is quite rare and most of them are saccular in shape and single in number. The authors report a case of P4 segment aneurysm of left posterior cerebral artery, successfully treated by clipping cross neck and reviewed the literature, and discussed their anatomy, clinical feature, location, and variable operative methods.

Multiple Intracranial Aneurysms: A Case Report of Patient with Nine Multiple Intracranial Aneurysms

One case of multiple intracranial aneurysms is presented. On carotid angiogram, nine aneurysmal sacs including a giant aneurysm of left middle cerebral artery were detected on the right distal anterior cerebral artery, anterior communicating artery, bifurcation of both internal carotid artery, both middle cerebral artery, and left posterior communicating artery. The authors reviewed the literature, and discussed the incidence, determining the site of rupture, and the operative methods of multiple intracranial aneurysms.

Traumatic Cerebral Aneurysm: A Case of Traumatic False Aneurysm of the Superficial Temporal Artery

A case of iatrogenic false aneurysm of the superficial temporal artery is presented. Direct injection of Urograffin into the pulsatile mass showed aneurysmal dilatation, 3x2cm sized, of the superficial temporal artery. Aneurysm excision is indicated to reduce the risk of hemorrhage from the subsequent head trauma, to relieve headache, and for any cosmetic defect. The authors have reviewed the literature, and discussed the incidence, classification, pathogenesis, clinical and angiographic diagnosis, differential diagnosis, and treatment.

Intracranial Aneurysmal Rupture during Pregnancy: A Case Report

A multiparous 28-year-old woman, suffering ruptured intracranial aneurysm during pregnancy is presented. Clipping of the aneurysm was performed in 32 weeks of gestational age. Three weeks after operation, she delivered vaginally without complication. Delivery may be managed according to obstetrical indication following surgical correction of the aneurysm. The authors reviewed the literature, and discussed the neurosurgical and obstetric management of such patients.

Application of Fenestrated Clip in the Intracranial Aneurysms: Report of Four Cases

Some aneurysms with peculiar shapes, large sized or in unusual location cannot be obliterated by ordinary methods. We present four cases using two kinds of fenestrated clips. There were 4 aneurysms in the 4 patients:3 saccular and 1 fusiform aneurysm. Two aneurysms were located in anterior communicating artery, one left carotico-opthalmic artery, and one distal middle cerebral artery. All of the aneurysms were successfully obliterated. Our results suggest that the various shape of fenestrated clips may be benefit for clipping difficult aneurysms, which would not be clipped with ordinary one.