PDF(Pubmed)
Abstract：
The International Subarachnoid Aneurysm Trial led to a shift from clipping to endovascular coiling as the primary therapy for cerebral aneurysm particularly in the management of posterior circulation aneurysm. However, endovascular therapy is often unavailable in low-resource settings, emphasizing the importance of maintaining surgical skill sets in resource-poor countries. This article presents a detailed case report on the successful microneurosurgical management of a 65-year-old female with a history of headache and weakness with past history of hypertension and a right posterior cerebral artery territory infarct who was diagnosed with a ruptured aneurysm situated within the intracranial vertebral artery. Patient was operated with the far lateral approach and clipping of the aneurysm. This case report elucidates the intricate surgical techniques employed, and the challenges neurosurgeons encountered in treating posterior circulation intracranial aneurysms, particularly those with ruptured complications. The aneurysms\' intricate anatomy and increased rupture risk necessitate a meticulous microneurosurgical approach. The severity of subarachnoid hemorrhage from ruptured aneurysms increases morbidity and mortality rates.
摘要：
国际蛛网膜下腔动脉瘤试验导致从夹闭到血管内盘绕的转变，作为脑动脉瘤的主要治疗方法，特别是在后循环动脉瘤的治疗中。然而,在低资源环境中，血管内治疗通常不可用，强调在资源贫乏的国家保持外科技能的重要性。本文介绍了一例65岁女性的成功显微手术治疗的详细病例报告，该女性有头痛和虚弱的病史，既往有高血压病史和右大脑后动脉区梗塞，被诊断为颅内动脉瘤破裂椎动脉。患者采用远外侧入路和动脉瘤夹闭手术。此病例报告阐明了所采用的复杂手术技术，以及神经外科医生在治疗后循环颅内动脉瘤时遇到的挑战，尤其是那些有破裂并发症的患者。动脉瘤复杂的解剖结构和增加的破裂风险需要细致的显微神经外科手术入路。动脉瘤破裂引起的蛛网膜下腔出血的严重程度会增加发病率和死亡率。
