Ischemic Complication after Surgery for Posterior Communicating Artery Aneurysm.

Cha, Jae Hun; Park, In Sung; Yi, Jiang; Kim, Ki Jung; Hwang, Soo Hyun; Han, Jong Woo

Original Article

Journal of Korean Neurosurgical Society 2003;33(2): 137-141.

Jae Hun Cha, In Sung Park, Jiang Yi, Ki Jung Kim, Soo Hyun Hwang, Jong Woo Han

¹Department of Neurosurgery, Gyeongsang National University College of Medicine, Gyeongsang Institute of Health Science, Jinju, Korea.
²Department of Neurosurgery, Hunchun City Hospital, Hunchun, China.

ABSTRACT

OBJECTIVE
The purpose of this study is to elucidate the causes of the ischemic complication after surgery for posterior communicating artery aneurysm and to represent the ways of preventing or minimizing this specific complication.
METHODS
Between January 2000 and December 2001, fifty one patients were treated for the posterior communicating artery aneurysm. The medical records and neuroimaging studies of the patients were reviewed retrospectively. RESULTS: Among the series of 51 surgically treated patients, the authors experienced 6 cases of ischemic complication involving 3 thalamus, 2 posterior cerebral artery territory and 1 periventircular white matter. Four patients were treated by aneurysmal neck clipping and one patient with fusiform aneurysm and one patient with infundibulum at internal carotid-posterior communicating artery junction by parent artery trapping and parent artery occlusion, respectively. In 4 cases with aneurysmal clipping the authors could not confirm the patency of the parent artery or posterior communicating artery during operation by the obstacle such as internal carotid artery and/or aneurysmal dome. The neurological deficits developed postoperatively were improved or subside during hospital courses and all six patients showed good outcome(Glasgow Outcome Scale score V) at discharge. CONCLUSION: In most cases the posterior communicating artery itself can be separated from the neck of the aneurysm and thereby preserved to avoid a significant infarct in the thalamus and occipital lobe.

Key Words: Posterior communicating artery aneurysm; Surgery; Ischemic complication