Ischemic Complication after Surgery for Posterior Communicating Artery Aneurysm

ABSTRACT

OBJECTIVE: The purpose of this study is to elucidate the causes of the ischemic complication after surgery for posterior communicating artery aneurysm and to represent the ways of preventing or minimizing this specific complication. METHODS: Between January 2000 and December 2001, fifty one patients were treated for the posterior communicating artery aneurysm. The medical records and neuroimaging studies of the patients were reviewed retrospectively. RESULTS: Among the series of 51 surgically treated patients, the authors experienced 6 cases of ischemic complication involving 3 thalamus, 2 posterior cerebral artery territory and 1 periventircular white matter. Four patients were treated by aneurysmal neck clipping and one patient with fusiform aneurysm and one patient with infundibulum at internal carotid-posterior communicating artery junction by parent artery trapping and parent artery occlusion, respectively. In 4 cases with aneurysmal clipping the authors could not confirm the patency of the parent artery or posterior communicating artery during operation by the obstacle such as internal carotid artery and/or aneurysmal dome. The neurological deficits developed postoperatively were improved or subside during hospital courses and all six patients showed good outcome(Glasgow Outcome Scale score V) at discharge. CONCLUSION: In most cases the posterior communicating artery itself can be separated from the neck of the aneurysm and thereby preserved to avoid a significant infarct in the thalamus and occipital lobe.