Saturday, January 3, 2015

Subtemporal approach for distal basilar occlusion for giant aneurysm. Nuances and advantages of the subtemporal approach

Subtemporal approach for distal basilar occlusion for giant aneurysm. Nuances and advantages of the subtemporal approach
Journal of Neurosurgery: Neurosurgical FOCUS: Table of Contents

Neurosurgical Focus, Volume 38, Issue VideoSuppl1, Page Video 5, January 2015.
We described the subtemporal approach, which was used for distal basilar artery occlusion in a patient with a symptomatic giant unclippable aneurysm. We discuss issues related to positioning and lumbar drainage. We illustrate the basic steps: identification of the tentorial notch; sharp opening of the arachnoid behind the third nerve; placement of a fixed mechanical retractor to "hold" the brain; identification of the third nerve and mobilization from arachnoid attachments; identification of the course and insertion of the fourth nerve; division and retraction of the tentorial edge to enhance exposure; preparation of the "perforator-free zone"; and final clip application followed by ICG fluorescein angiography. We show some of the areas exposed with this approach. The video can be found here: http://youtu.be/S_NLIjKQL_o.

Original Article: http://thejns.org/doi/abs/10.3171/2015.V1.FOCUS14536?ai=rw&mi=3ba5z2&af=R

No comments:

Post a Comment