RESUMO
The surgical treatment of aneurysms that arise at the origin of the pericallosal artery is technically difficult. This report describes a technique that improves the exposure of the proximal vasculature during a craniotomy for pericallosal aneurysms. A portion of the corpus callosum was resected in two patients before the manipulation of their aneurysms. The resection provided excellent exposure of the A2 segment of the anterior cerebral artery, and both aneurysms were clipped safely. Neither patient exhibited signs of hemispheric disconnection. The authors conclude that partial callosal resection improves access to the proximal vessels during procedures for pericallosal aneurysms.
Assuntos
Corpo Caloso/cirurgia , Aneurisma Intracraniano/cirurgia , Adulto , Craniotomia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistema Nervoso/fisiopatologia , Período Pós-OperatórioRESUMO
Two cases of the spontaneous occurrence of spinal epidural hematomas of the high thoracic area are reported. Both acute and subacute presentations of paraplegia are represented. Neither patient had experienced any significant antecedent trauma. No predisposing medical conditions were present. Both patients recovered to independent ambulation following timely operative intervention. The pertinent literature on spinal epidural hematomas is reviewed, and the differential diagnosis of this entity is discussed. The need for prompt diagnosis and surgical treatment to achieve the best neurological outcome is emphasized.
Assuntos
Hematoma Epidural Craniano/etiologia , Vértebras Torácicas , Feminino , Hematoma Epidural Craniano/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Mielografia , Compressão da Medula Espinal/etiologia , Doenças da Coluna Vertebral/diagnóstico por imagem , Doenças da Coluna Vertebral/etiologia , Tomografia Computadorizada por Raios XRESUMO
A patient presented with spontaneous subarachnoid hemorrhage after a prolonged episode of coughing. A preoperative computed tomographic (CT) scan confirmed subarachnoid hemorrhage, but demonstrated no other lesion. Arteriography revealed an ophthalmic artery aneurysm. Operation revealed the aneurysm to be intracavernous without sign of prior rupture; however, a small hemorrhagic meningioma was removed from the ipsilateral anterior clinoid process. In this case, coincidental meningioma and aneurysm presented as a subarachnoid hemorrhage secondary to tumor hemorrhage. The follow-up of cases of subarachnoid hemorrhage with negative arteriography with sequential CT scans is discussed.
