추골동맥 몸통부 및 후·하소뇌동맥 근위부 동맥류에 대한 원위측후두하접근법을 통한 수술 결과

• 영문명: Surgical Results of Far Lateral Suboccipital Approach for the Vertebral Artery Trunk and Proximal Posteroinferior Cerebellar Artery Aneurysms
• 발행기관: 대한두개저학회
• 저자명: 조현(Hyun Cho) 김재민(Jae Min Kim) 정진환(Jin Hwan Cheong) 김성수(Sung Soo Kim) 백광흠(Koang Hum Bak) 김충현(Choong Hyun Kim)
• 간행물 정보: 『대한두개저학회지』제1권 제2호, 63~69쪽, 전체 7쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2006.12.30

영문 초록

Vertebral artery (VA) trunk and proximal posteroinferior cerebellar artery (PICA) aneurysms are challenging problem to treat surgically, with high reported perioperative complication rates. We describe the postoperative complications and clinical outcomes obtained via a far lateral suboccipital approach in 3 ruptured VA trunk and 6 ruptured proximal PICA aneurysms. Datas were collected retrospectively about the 3 VA trunk and 6 proximal PICA aneurysms treated surgically by a single surgeon between January 2001 and December 2004. Direct aneurysm clippings were achieved in 7 cases. In 2 cases, trappings without a revascularization procedure were used for dissecting VA aneurysms. Three patients(33.3%) who had the postoperative mild to moderate low cranial nerve palsy (LCNP) completely recovered within 3 months. Although the surgical clipping of VA trunk and proximal PICA aneurysms is very difficult, a far lateral suboccipital approach can provide the adequate space to clip without undue manupulation of the low cranial nerves and with minimal cerebellar retraction. The authors recommend that surgical obliteration of the aneurysm via the far lateral suboccipital approach be considered a first-line therapeutic option for the favorable outcomes and low postoperative morbidity in this subset of patients.

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키워드

Far lateral suboccipital approach Vertebral artery trunk Proximal posteroinferior cerebellar artery Aneurysm