Surgery for paraclinoidal carotid artery aneurysms

H. H. Batjer, T. A. Kopitnik, Cole A. Giller, D. S. Samson

Research output: Contribution to journalArticle

115 Citations (Scopus)

Abstract

Aneurysms arising from the proximal carotid artery between the roof of the cavernous sinus and the origin of the posterior communicating artery pose conceptual and technical surgical problems with regard to acquisition of proximal control and safe intracranial exposure. Over the past 3 1/2 years, 89 patients with paraclinoidal aneurysms have been treated at the University of Texas Southwestern Medical Center. Thirty-nine (44%) of these patients presented with subarachnoid hemorrhage. A total of 149 aneurysms and six arteriovenous malformations have been identified in this patient group such that 38 (43%) of the patients suffered multiple vascular anomalies. Temporary artery occlusion has been employed during operation in 48 cases (54%), permanent carotid artery occlusion in four (4%), and hypothermic circulatory arrest in two (2%). Twenty-two patients harbored giant aneurysms, seven of which had ruptured. Outcome was considered good in 77 patients (86.5%), fair in eight (9%), and poor in three (3%); one patient died. This concentrated experience permitted a practical anatomical grouping of aneurysms into three type-carotid-ophthalmic artery aneurysms with a superior or superomedial projection (44 cases); superior hypophyseal aneurysms with a medial or inferomedial projection (26 cases); and proximal posterior carotid artery wall aneurysms projecting posteriorly or posterolaterally (19 cases). Despite the fact that paraclinoidal aneurysms often disobey the traditional teachings of aneurysm development, having no vessel of origin or clear hemodynamic cause, this practical grouping has allowed individualized and focused operative approaches unique to each aneurysm projection with good visual function and outcome in most patients.

Original languageEnglish (US)
Pages (from-to)650-658
Number of pages9
JournalJournal of neurosurgery
Volume80
Issue number4
DOIs
StatePublished - Jan 1 1994
Externally publishedYes

Fingerprint

Carotid Arteries
Aneurysm
Arteries
Ophthalmic Artery
Cavernous Sinus
Arteriovenous Malformations
Subarachnoid Hemorrhage
Blood Vessels
Teaching
Hemodynamics

Keywords

  • carotid artery
  • paraclinoidal aneurysm
  • temporary artery occlusion

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Batjer, H. H., Kopitnik, T. A., Giller, C. A., & Samson, D. S. (1994). Surgery for paraclinoidal carotid artery aneurysms. Journal of neurosurgery, 80(4), 650-658. https://doi.org/10.3171/jns.1994.80.4.0650

Surgery for paraclinoidal carotid artery aneurysms. / Batjer, H. H.; Kopitnik, T. A.; Giller, Cole A.; Samson, D. S.

In: Journal of neurosurgery, Vol. 80, No. 4, 01.01.1994, p. 650-658.

Research output: Contribution to journalArticle

Batjer, HH, Kopitnik, TA, Giller, CA & Samson, DS 1994, 'Surgery for paraclinoidal carotid artery aneurysms', Journal of neurosurgery, vol. 80, no. 4, pp. 650-658. https://doi.org/10.3171/jns.1994.80.4.0650
Batjer, H. H. ; Kopitnik, T. A. ; Giller, Cole A. ; Samson, D. S. / Surgery for paraclinoidal carotid artery aneurysms. In: Journal of neurosurgery. 1994 ; Vol. 80, No. 4. pp. 650-658.
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