Microsurgical Techniques for Paraclinoid Aneurysms: A Single-Center Series.

Area of Science:

• Neurosurgery
• Vascular Neurosurgery
• Cerebrovascular Surgery

Background:

• Microsurgery is the primary treatment for paraclinoid aneurysms in resource-limited settings.
• This study evaluates institutional experience and functional outcomes of microsurgical treatment for these aneurysms.

Purpose of the Study:

• To assess the efficacy and outcomes of microsurgical interventions for paraclinoid aneurysms.
• To identify predictors of good functional outcomes after treatment.

Main Methods:

• Retrospective review of clinical records for 56 patients with 58 paraclinoid aneurysms.
• Multivariable logistic regression was used to analyze predictors of good functional outcomes (modified Rankin Scale score ≤ 2).

Main Results:

• Most aneurysms were in the ophthalmic segment, ruptured, and wide-necked.
• Microsurgical repair involved clipping (87.5%) or clipping with bypass (12.5%), often with minipterional craniotomy and extradural anterior clinoidectomy.
• 91.1% of patients achieved good functional outcomes at 6 months, with 72.4% experiencing visual improvement. Higher Hunt and Hess scores correlated with poorer outcomes (OR: 0.25).

Conclusions:

• Microsurgical treatment plays a crucial role in managing paraclinoid aneurysms.
• These techniques are essential for optimizing functional outcomes and reducing morbidity, even in cases of subarachnoid hemorrhage and delayed treatment.