superior cerebellar aneurysm clipping

The cerebellar aneurysm is rare, occurring in the distal corner of the superior basilar artery, located in the narrow space between the superior cerebellar artery and the posterior cerebral artery, in which the oculomotor nerve passes through the intertrochanteric fossa. The gap is close to the aneurysm and often has adhesions, which are easily damaged when treating an aneurysm. Treatment of diseases: intracranial aneurysm aortic aneurysm Indication Upper cranial aneurysm clipping is applicable to: 1. The condition of the upper cerebellar aneurysm is improved or stabilized after rupture, and can withstand craniotomy. 2. Unexplained unruptured aneurysm. Contraindications 1. The condition of the aneurysm is critical after rupture, and the brain is swollen or has severe cerebral vasospasm. 2. The patient has a serious systemic disease and cannot tolerate the operator. Preoperative preparation 1. Brain CT scan to observe the distribution of subarachnoid hemorrhage, with or without intracranial hematoma, hydrocephalus and brain swelling. 2. Cerebral angiography, it is best to perform digital subtraction of whole brain angiography to understand the size, shape and location of aneurysms, and the extent and extent of cerebral vasospasm. Multiple aneurysms can sometimes be found in order to plan surgical approaches and procedures. 3. Perform a detailed physical examination to estimate the patient's ability to withstand surgery. 4. Relieve the patient's fear of surgery, and give sedatives before the operation to prevent the patient from rupturing due to preoperative emotional stress. 5. Wash the scalp one day before the operation, shave the hair on the morning of the operation, wash and disinfect the scalp, and wrap it in a sterile towel. 6. Prepare for blood transfusion and give antibiotics to prevent infection. Surgical procedure Wing point approach As with the basilar artery bifurcation aneurysm clipping, it can be accessed from the ipsilateral or contralateral side of the aneurysm. When entering from the same side, the top of the aneurysm often obstructs the neck of the tumor, so that it cannot be separated, and the oculomotor nerve is also blocked between the line of sight and the aneurysm. It must be retracted to reveal, and the tumor can be seen first from the opposite side. neck. However, if the operator is a right-hander, it is inconvenient to enter from the left side. 2. Under the way It is the same as the approach of the basilar artery bifurcation aneurysm. If the position of the bifurcation is very low, the edge of the cerebellar incision should be cut, the blood clot should be removed, and the adhesion can be separated to reveal the neck. Eye movements often hinder the operation, and can be pulled up or down to select the appropriate tumor clip to clamp the neck. 3. Under the pillow The aneurysm of the distal segment of the superior cerebellar artery from the pons of the cerebral artery can be clipped through the suboccipital approach. complication Ocular nerves and trochlear nerve damage.