Microneurosurgery: volume. 2 by Mahmut Gashni Yasargil

By Mahmut Gashni Yasargil

Medical concerns, surgical procedure of the Intracranial Aneurysma and effects

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Microneurosurgery: volume. 2

Medical concerns, surgical procedure of the Intracranial Aneurysma and effects

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An aneurysm of this group may extend posteriorly and is often buried in the lateral orbital gyri; a point to remember when traction is applied to the undersurface of the frontal lobe. I Subchiasmatic 3) Inferomedial. This is the most common presentation of internal carotid-ophthalmic artery aneurysm, as it was found in 20 of 39 cases (including the 6 bilateral cases). The fundus lies beneath the adjacent optic nerve, often elevating it, and compressing it. The aneurysm is in a close relationship with the pituitary stalk, which may be displaced laterally towards the opposite side or inferiorly.

When thrombosed they may be confused with suprasellar tumors (see Vol. I, Fig 254 A-D). In one case, the fundus of a Subchiasmatic aneurysm protruded between the optic nerves and ruptured into the overlying gyrus rectus, imitating an anterior communicating artery aneurysm (see Vol. I, Fig 259 A-B). 4) Giant subchiasmal aneurysms filling the entire suprasellar area have been termed "global" (Thurel et al 1974). The aneurysm may involve both ICA, the PcoA and its branches, the ACA, the AcoA and its branches, both optic nerves, and the chiasm.

Cooper (1836) reported the first successful operation of an aneurysm of the cervical carotid artery. Killian (1951) reported 173 aneurysms of the ICA in the neck out of 787 cases of extracranial carotid aneurysms. Brihaye (1979) reviewed the world literature and found 47 well documented cases between 1931 and 1977. These cases are listed in the publication of Pia (1979), Table I, pages 47-54. Schechter (1979) also reviewed the world literature and found 853 extracranial carotid aneurysms in 830 patients between 1687 and 1977.

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