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Microsurgical treatment of paraclinoid aneurysms by extradural anterior clinoidectomy: The fujita experience

 Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan

Correspondence Address:
Ahmed Ansari,
Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, 3-6-10 Otobashi, Nakagawa Ward, Nagoya, Aichi Prefecture
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_130_17

Introduction: Paraclinoid aneurysms pose technical difficulty in their approach, mainly because of their close proximity to neurovascular structures, deeper location, and a smaller corridor. Extradural anterior clinoidectomy is a highly beneficial technique in such cases, making more space to deal with these aneurysms. We describe our method of performing extradural anterior clinoidectomy in such patients. Materials and Methods: A total of 33 cases of paraclinoid internal carotid artery aneurysms presenting to Fujita Health University Banbuntane Hospital, Japan, were included. Females comprised the majority with 32 cases; the mean age was 54.8 years (range: 35–74 years). The mean size of the paraclinoid aneurysm was 5.3 mm (range: 3–12 mm). Results: Nine paraclinoid aneurysms were found projecting dorsally, 7 laterally, and 17 medially (Kazuhiko Kyoshim et al's. classification). An immediate complete occlusion rate of 100% was present. Visual disturbance was found in 6.2% of our patients. One of our patients developed permanent loss of vision. Conclusion: Extradural anterior clinoidectomy enables a better exposure to paraclinoid aneurysms. Precise anatomical knowledge along with microsurgical tactics is required to prevent and manage potential complications to achieve good outcomes.

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    -  Yamada Y
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