英文病例手术预案左侧大脑中动脉动脉瘤

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Family History:
Mother died of Cerebral Hemorrhage. Brother has an EMB of Ruptured anterior communicating AN recently.
PE: --
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CT (Jan. 16th 2010 Local Hosp. )
L-MAC AN clipping
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Female, 53 y/o
Abstract
6 years ago, patient have a thorough examination. MRI and MRA in local hospital indicated L-MCA unruptured aneurysm
There is no SAH and calcification
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MRI (Jan. 16th 2010 Local Hosp. )
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MRA (Jan. 16th 2010 Local Hosp. )
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DSA and3D reconstruction (Jan. 31th 2010 Local Hosp. )
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) 3D reconstruction (Jan. 31th 2010 Local Hosp.
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The patient has MRI and MRA every year The size of AN has no growth
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MRI T1 (Dec. 22th 2015 Local Hosp. )
Promixal occlusion of parent artery or wrapping of inferior trunk of M2 is needed
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CTA (Feb. 2th 2016 Local Hosp )
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Diagnosis
L-MCA AN
L-MCA AN clipping
Байду номын сангаас
Pterion approach (Left)
Bypass
Treatment
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Keypoints
Perservation of Superfical temporal artery within scalp preparing for bypass. MEP monitoring for function preservation during temperal occlusion. Preparation for secure 2 branches of STA-M4 bypass for maintaining the normal blood
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MRI T2 (Dec. 22th 2015 Local Hosp. )
There is no thrombus.
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CT (Feb. 2th 2016 Local Hosp. )
There is no calcification
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CTA (Feb. 2th 2016 Local Hosp )
circulation of Lt MCA region during temporal occlusion or proximal occlusion. Try to reconstruct of M2 Aneurysm complex with multiple clips technique. If it is failed,
DSA in local hospital show the AN located M1 segment of L-MCA
Past history: Hypertension 4yr
Treatment of Irbesartan and Hydrochlorothiazide (Maximum 80-130mmHg)