Abstract
The use of minimally invasive techniques has not yet been reported for the treatment of recurrent aneurysms after coil embolization. A 47-year-old man with a long history of headaches had an anterior communicating aneurysm that had previously been coil embolized. Three-year follow-up angiography showed a significant recurrence. A 50-year-old woman with subarachnoid hemorrhage and acute visual loss underwent coil embolization of a large ophthalmic artery aneurysm, which recurred 3 months later. In both cases, a keyhole fronto-orbital one-piece craniotomy was performed. In the first patient, the aneurysm was clip ligated. The coil mass, which had eroded through the dome, was excised. In the second patient, the anterior clinoid was removed and the aneurysm was clip ligated. Postoperative angiography showed no residual aneurysm and no evidence of branch or parent vessel compromise in either patient. Both patients had an uncomplicated postoperative course. Recurrent previously coiled aneurysms are technically challenging to treat. A minimal fronto-orbital craniotomy provides a sufficiently capacious working space for successful treatment of some recurrent aneurysms of the anterior circulation.
Original language | English (US) |
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Pages (from-to) | 70-73 |
Number of pages | 4 |
Journal | Minimally Invasive Neurosurgery |
Volume | 49 |
Issue number | 2 |
DOIs | |
State | Published - Apr 2006 |
Externally published | Yes |
Keywords
- Aneurysm
- Coil embolization
- Keyhole craniotomy
- Subarachnoid hemorrhage
ASJC Scopus subject areas
- Surgery
- Clinical Neurology