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[The surgery of giant symptomatic cavernous sinus aneurysms].

Fuyu Wang1, Zhenghui Sun1, Bainan Xu1

  • 1Department of Neurosurgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.

Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery]
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Surgical management for giant symptomatic cavernous sinus aneurysms, including bypass and carotid occlusion, shows effectiveness in selected patients. Careful pre-operative and intra-operative assessments guide successful treatment outcomes.

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Area of Science:

  • Neurosurgery
  • Vascular Neurology
  • Interventional Neuroradiology

Context:

  • Giant symptomatic cavernous sinus aneurysms pose significant management challenges.
  • Traditional treatment options have limitations.
  • Surgical intervention is often necessary for complex cases.

Purpose:

  • To evaluate the efficacy and outcomes of surgical strategies for giant symptomatic cavernous sinus aneurysms.
  • To assess the role of aneurysm trapping with bypass and proximal carotid occlusion.
  • To determine the impact of pre-operative and intra-operative monitoring on patient results.

Summary:

  • Twenty-three patients with giant symptomatic cavernous sinus aneurysms underwent surgical treatment, including aneurysm trapping with bypass and proximal carotid occlusion.
  • Pre-operative digital subtraction angiography (DSA) and balloon occlusion test (BOT) guided surgical decisions.
  • Intra-operative neurophysiological monitoring and CT perfusion were utilized during procedures.
  • Outcomes included symptom improvement in 4, no change in 10, and new deficits in 9 patients, with 19 achieving good Glasgow Outcome Scale scores.

Impact:

  • Aneurysm trapping with bypass and proximal carotid occlusion are effective and reliable procedures for selected patients.
  • Pre-operative BOT, intra-operative neurophysiological monitoring, and CT perfusion are crucial for successful management.
  • This study provides insights into surgical decision-making and patient outcomes for complex aneurysms.