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Kinked Perforator Due to Clipping of Parent Vessel Aneurysm: Technical Note and Lessons Learned
Jorn Van Der Veken1, Michael J Mulcahy1, Timothy J Harrington2
1Department of Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney, New South Wales, Australia.
Background:
Adverse outcomes after aneurysm clipping can be potentially reversible, when managed appropriately.
Methods:
This is a case report describing kinking of a perforator due to clipping of parent vessel aneurysm.
Results:
Complete recovery of a high-grade motor deficit was achieved after instant reintervention with application of smaller clips in combination with gelfoam soaked in papaverine.
Conclusion:
Use of evoked potentials and intraoperative digital subtraction angiography are recommended and may help in preclinical diagnosis. Knowledge of delayed perforator kinking as a complication may lead to a more rapid diagnosis and management.
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