Unsuccessful bypass and trapping of a giant dolichoectatic thrombotic basilar trunk aneurysm. What went wrong?
Nicola MontemurroPaolo PerriniMichael T LawtonPublished in: British journal of neurosurgery (2022)
Aneurysms of the basilar trunk represent an exceptional challenge to the neurosurgeon, due to high mortality and surgical morbidity. We present a 69-year-old man with a giant dolichoectatic thrombotic basilar trunk aneurysm (BTA), who underwent right orbitozygomatic craniotomy, posterior cerebral artery (PCA) to right middle cerebral artery (MCA) bypass and trapping of the BTA. Unfortunately, patient died after surgery due to multiple foci of intraparenchymal haemorrhage and thrombosis of a short segment proximal to aneurysm trapped and his body was donated to the hospital, giving us the unique opportunity to compare intraoperative details with anatomical dissection findings, according to our previously published cadaveric neurosurgical research. The great and unique opportunity of this reported case, to learn by watching and watching again what has been done during surgery, to observe small vessels and brainstem perforators and to look at stiches of the bypass, SVG and the position of the clips, permits to refine the theoretical and practical skills for the treatment of complex aneurysms such as that one reported.
Keyphrases
- middle cerebral artery
- coronary artery
- lower limb
- minimally invasive
- abdominal aortic aneurysm
- internal carotid artery
- pulmonary embolism
- healthcare
- coronary artery bypass
- case report
- subarachnoid hemorrhage
- cardiovascular events
- rare case
- emergency department
- ultrasound guided
- adverse drug
- combination therapy
- acute coronary syndrome
- cardiovascular disease
- blood brain barrier
- electronic health record