Turkish Neurosurgery 2013 , Vol 23 , Num 6
3.0-T Diffusion Images After Clipping of Middle Cerebral Artery Aneurysm
Yasuo MURAI1, Koji ADACHI1, Fumihiro MATANO1, Ryo TAKAGI2, Yasuo AMANO2, Shiro KOBAYASHI3, Takayuki KITAMURA1, Akira TERAMOTO1
1Nippon Medical School, Department of Neurosurgery, Tokyo, Japan
2Nippon Medical School, Department of Radiology, Tokyo, Japan
3Chiba Hokuso Hospital, Nippon Medical School, Department of Neurosurgery, Chiba, Japan
DOI : 10.5137/1019-5149.JTN.7886-13.1 AIM: Replacement of aneurysm clips or temporary parent artery occlusion during aneurysm clipping (AC) carries the risk of inducing postoperative neurologic deficits. When studying the risk of surgical complications associated with cerebral aneurysms, patients with similar conditions should be compared to eliminate the influence of rupture and location of aneurysm.

MATERIAL and METHODS: We used 3.0-Tesla (3.0T) magnetic resonance diffusion-weighted imaging (DWI) and magnetic resonance angiography (MRA) to analyze surgical complications after AC. A total of 42 AC procedures for 40 unruptured and 2 delayed-phase ruptured MCA aneurysms were evaluated.

RESULTS: In six patients, temporary parent artery occlusion was performed. Asymptomatic hyperintensities were observed on DWI of three patients. In one patient, an asymptomatic lesion was most likely caused by a small contusion that occurred during dissection of an aneurysm attached to the brain surface. In two patients, asymptomatic cortical lesions were caused by brain surface contusions due to lacerations of the open dura. No symptomatic hyperintensities on DWI were observed after surgery. No fixed ischaemic neurologic deficits resulted from AC.

CONCLUSION: Although some postoperative abnormalities were observed with 3.0T DWI, we found clipping of MCA aneurysms to be a safe procedure with a low risk of ischaemic complications. Keywords : Cerebral aneurysm, Clipping, Complications, Ischemia

Corresponding author : Yasuo Murař, ymurai@nms.ac.jp