Surgically Relevant Bony Anatomical Variations in Paraclinoid Aneurysms-Three-Dimensional Multi-Detector Row Computed...

Area of Science:

• Neurosurgery
• Radiology
• Anatomy

Background:

• Paraclinoid aneurysms pose surgical challenges due to complex anatomy.
• Surgically relevant bony anatomical variations can impact surgical approaches and outcomes.
• Computed tomography (CT) cerebral angiography is crucial for visualizing these variations.

Purpose of the Study:

• To determine the prevalence of caroticoclinoid foramen, interclinoid osseous bridge, and anterior clinoid pneumatization.
• To assess the association of these variations with paraclinoid aneurysms.
• To emphasize the importance of reporting these variations in radiological studies.

Main Methods:

• Retrospective analysis of 54 CT cerebral angiography studies of patients with paraclinoid aneurysms.
• Three-dimensional reconstructions and multiplanar reconstructions with bone algorithms were used.
• Evaluation of caroticoclinoid foramen, interclinoid osseous bridge, and anterior clinoid pneumatization.

Main Results:

• Caroticoclinoid foramen observed in 22.22%, interclinoid osseous bridge in 0.9%, and anterior clinoid pneumatization in 11.11% of cases.
• Incomplete caroticoclinoid foramen and Type I pneumatization were the most common subtypes.
• Caroticoclinoid foramen was most prevalent in clinoid segment aneurysms (12 cases).

Conclusions:

• Significant proportions of caroticoclinoid foramen and anterior clinoid pneumatization are present in paraclinoid aneurysm cases.
• These bony anatomical variations are surgically relevant.
• Radiological reports should detail these variations for surgical planning.