Abordaje temporopolar para la cirugía de aneurismas intracraneales de la circulación posterior: Informe de 2 casos / Temporopolar approach to intracraneal aneurysms surgery of the posterior circulation: to cases report

Los aneurismas intracraneales de la circulación posterior representan un reto para la neurocirugía contemporánea y para la neurorradiología intervencionista, debido a la complejidad anatómica de su topografía que predispone a la aparición de complicaciones. La oclusión endovascular representa la opción más acertada para el tratamiento de estas lesiones, pero al no existir una cobertura adecuada para todos los pacientes, la microcirugía representa una alternativa para el manejo de los pacientes con esta compleja enfermedad. En el presente trabajo se presentan dos casos intervenidos quirúrgicamente, uno con un aneurisma del tope de la basilar y otro con uno de la arteria cerebelosa superior izquierda, en los que se utilizó un abordaje temporopolar descrito por Sano, con resultados satisfactorios. Se concluye que este abordaje representa una alternativa adecuada al resto de las técnicas usadas para el tratamiento quirúrgico de estas lesiones

Intracranial aneurysms of the posterior circulation represent a challenge for contemporary neurosurgery and interventional neuroradiological procedures due to the anatomical complexity of its topography that predispose on the occurrence of complications. The endovascular occlusion represents the best option for the treatment of these injuries, but at not existing a coverage suitable for all patients, microsurgery continues representing an alternative for the management of patients with this complex disease. In this paper we present two cases operated, one with a basilar tip aneurysms and another one in the left superior cerebellar artery in which a temporopolar approach described by healthy, with successful results was used. We conclude that this approach represents an alternative to the rest of the techniques used for the surgical treatment of these injuries

EFFECT OF PAPAVERINE ON CEREBRAL VASOSPASM FOLLOWING CEREBRAL ANEURYSM OPERATION / 解放军医学杂志

To evaluate the effect of papaverine administered via different routes following cerebral aneurysm operation, 43 cerebral aneurysm patients were divided randomly into two groups: A and B. Patients of group A were placed with a silicagel tube in cerebral ventricle and lavaged repeatedly with papaverine solution during operation and following 3 days after operation, those of group B were intramuscularly injected with papaverine 30mg, 3 times per day,for one week. By analysis of clinical features and TCD data, both A and B could cure cerebral vasospasm, but group A was obviously superior to group B. Our conclusion is that papaverine solution lavaged locally can effectively prevent cerebral vasospasm after cerebral aneurysm operation .