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Medicina clínica y social

On-line version ISSN 2521-2281

Abstract

GALLARDO, Angel Jesús Lacerda  and  PAZOS, Miguel Mazorra. Microsurgery and adjuvant strategies in the treatment of intracranial aneurysms. Med. clín. soc. [online]. 2023, vol.7, n.3, pp.194-201. ISSN 2521-2281.  https://doi.org/10.52379/mcs.v7i3.295.

Introduction:

The human risk of suffering from an intracranial aneurysm is estimated between 1-2%, in 80% of cases its presentation is a subarachnoid hemorrhage.

Objectives:

To evaluate the usefulness of different adjunctive maneuvers to facilitate micro dissection and clamping of the neck of intracranial aneurysms.

Method:

We have carried out a descriptive study including all the patients admitted in the neurosurgery department of “Roberto Rodríguez” Hospital in Moron, Ciego de Avila, Cuba with the diagnosis of intracranial aneurysms who were operated on through microsurgical cliping techniques in the period between january 1997 and december 2020.

Results:

201 patients were operated on, 198 (98.51%) with aneurysms of the anterior circulation and only 3 (1.49%), of the posterior circulation. A total of 252 sacs were approached, adjuvant strategies to the conventional procedure were used to facilitate the act of aneurysmal clamping, such as continuous spinal drainage, ventriculostomy to the outside for CSF drainage and continuous monitoring of ICP and brain retraction pressure, temporary closure of the mother artery, retrograde suction decompression in giant aneurysms. 74.62% of the cases recovered without any type of symptoms or sequelae, and mortality was 1.49%.

Discussion:

Microsurgery is an effective procedure, with a high efficiency index, for the treatment of intracranial aneurysms in our environment. Adjunctive strategies facilitate parenchymal relaxation, dissection, and clamping of the aneurysmal neck.

Keywords : Intracranial aneurysms; Microsurgery; Surgical treatment.

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