Superior hypophyseal artery aneurysm

Report of two cases

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✓ Two cases of saccular intracranial aneurysms arising from the superior hypophyseal artery take-off from the internal carotid artery are presented. The angiographic findings and technical details of the operative approach are discussed. Particular attention is focused on the use of fenestrated angled clips.

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Address reprint requests to: Wesley Y. Yapor, M.D., 707 North Fairbanks Court, Suite 911, Chicago, Illinois 60611.

© AANS, except where prohibited by US copyright law.

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Figures

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    Left carotid angiograms, anteroposterior (left) and lateral (right) views. Upper Pair: Preoperative studies showing a paraclinoid internal carotid aneurysm projecting inferiorly and medially (arrows). Lower Pair: Postoperative studies confirm obliteration of the aneurysm by a fenestrated angled Sugita clip with patency of internal carotid artery.

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    Drawing of the operative approach via a pterional craniotomy. Note removal of the anterior clinoid process for exposure. The superior hypophyseal artery take-off is at the origin of the medially directed aneurysm. For illustration, the aneurysm (ANR) is shown clearly exposed; in actuality, it typically lies beneath the optic nerve. ICA = internal carotid artery.

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    Left carotid angiograms, anteroposterior (left) and lateral (right) views. Upper Pair: Preoperative studies showing a large multilobular paraclinoid aneurysm (arrows) projecting posteriorly and medially (arrows). Center Pair: First postoperative studies showing partial (lateral) clipping of the aneurysm (arrows). Lower Pair: Second postoperative studies demonstrating obliteration of the aneurysm by a fenestrated angled Sugita clip and preserved patency of the internal carotid artery.

References

1.

Dolenc VV: A combined epi- and subdural direct approach to carotid-ophthalmic artery aneurysms. J Neurosurg 62:6676721985Dolenc VV: A combined epi- and subdural direct approach to carotid-ophthalmic artery aneurysms. J Neurosurg 62:667–672 1985

2.

Dujovny MKossovsky NKossowsky Ret al: Intracranial clips: an examination of the devices used for aneurysm surgery. Neurosurgery 14:2572671984Dujovny M Kossovsky N Kossowsky R et al: Intracranial clips: an examination of the devices used for aneurysm surgery. Neurosurgery 14:257–267 1984

3.

Fujita S: Fenestrated clips for internal carotid artery aneurysms. Technical note. J Neurosurg 65:1221231986Fujita S: Fenestrated clips for internal carotid artery aneurysms. Technical note. J Neurosurg 65:122–123 1986

4.

Gibo HLenkey CRhoton AL Jr: Microsurgical anatomy of the supraclinoid portion of the internal carotid artery. J Neurosurg 55:5605741981Gibo H Lenkey C Rhoton AL Jr: Microsurgical anatomy of the supraclinoid portion of the internal carotid artery. J Neurosurg 55:560–574 1981

5.

Heros RCNelson PBOjemann RGet al: Large and giant paraclinoid aneurysms: surgical techniques, complications, and results. Neurosurgery 12:1531631983Heros RC Nelson PB Ojemann RG et al: Large and giant paraclinoid aneurysms: surgical techniques complications and results. Neurosurgery 12:153–163 1983

6.

Kinjo TMizoi KTakahashi Aet al: [A successfully treated case of giant basilar artery aneurysm utilizing a balloon catheter occlusion and the brain protective substances.] No Shinkei Geka 14:3974021986 (Jpn)Kinjo T Mizoi K Takahashi A et al: [A successfully treated case of giant basilar artery aneurysm utilizing a balloon catheter occlusion and the brain protective substances.] No Shinkei Geka 14:397–402 1986 (Jpn)

7.

Ojemann RGHeros RCCrowell RM: Surgical Management of Cerebrovascular Diseaseed 2. Baltimore: Williams & Wilkins1988Ojemann RG Heros RC Crowell RM: Surgical Management of Cerebrovascular Disease ed 2. Baltimore: Williams & Wilkins 1988

8.

Sekhar LNHeros RC: Origin, growth, and rupture of saccular aneurysms: a review. Neurosurgery 8:2482601981Sekhar LN Heros RC: Origin growth and rupture of saccular aneurysms: a review. Neurosurgery 8:248–260 1981

9.

Sugita KKobayashi SKyoshima Ket al: Fenestrated clips for unusual aneurysms of the carotid artery. J Neurosurg 57:2402461982Sugita K Kobayashi S Kyoshima K et al: Fenestrated clips for unusual aneurysms of the carotid artery. J Neurosurg 57:240–246 1982

10.

Wirth FPLaws ER JrPiepgras Det al: Surgical treatment of incidental intracranial aneurysms. Neurosurgery 12:5075111983Wirth FP Laws ER Jr Piepgras D et al: Surgical treatment of incidental intracranial aneurysms. Neurosurgery 12:507–511 1983

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