Neurological Deterioration after Decompressive Suboccipital Craniectomy in a Patient with a Brainstem-compressing Thrombosed Giant Aneurysm of the Vertebral Artery
Journal of Cerebrovascular and Endovascular Neurosurgery
;
: 115-119, 2016.
Article
Dans Anglais
| WPRIM
| ID: wpr-11244
ABSTRACT
We experienced a case of neurological deterioration after decompressive suboccipital craniectomy (DSC) in a patient with a brainstem-compressing thrombosed giant aneurysm of the vertebral artery (VA). A 60-year-old male harboring a thrombosed giant aneurysm (about 4 cm) of the right vertebral artery presented with quadriparesis. We treated the aneurysm by endovascular coil trapping of the right VA and expected the aneurysm to shrink slowly. After 7 days, however, he suffered aggravated symptoms as his aneurysm increased in size due to internal thrombosis. The medulla compression was aggravated, and so we performed DSC with C1 laminectomy. After the third post-operative day, unfortunately, his neurologic symptoms were more aggravated than in the pre-DSC state. Despite of conservative treatment, neurological symptoms did not improve, and microsurgical aneurysmectomy was performed for the medulla decompression. Unfortunately, the post-operative recovery was not as good as anticipated. DSC should not be used to release the brainstem when treating a brainstem-compressing thrombosed giant aneurysm of the VA.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Tétraplégie
/
Thrombose
/
Artère vertébrale
/
Tronc cérébral
/
Anévrysme intracrânien
/
Décompression
/
Craniectomie décompressive
/
Anévrysme
/
Laminectomie
/
Manifestations neurologiques
Limites du sujet:
Humains
/
Mâle
langue:
Anglais
Texte intégral:
Journal of Cerebrovascular and Endovascular Neurosurgery
Année:
2016
Type:
Article
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