1.Surgery of the Brain Stem and 4th Ventricle(Luncheon Seminar-1 Challenges to Difficult Sugery,The 26^ Annual Meeting of The Japanese Congress of Neurological Surgeons)
1.脳幹・第四脳室の手術(LS-1 困難な手術への挑戦,ランチョンセミナー,第26回 日本脳神経外科コングレス総会)

Nobuhito Saito
2006 Japanese Journal of Neurosurgery  
Giant aneurysms create difficulties to clip because of com − binations of wide neck , partial thrombosis , hard thrombus , thick wall or calcification , perforators arising 丘om sac , deep location and dome projection obstructing the appr 〔 }ach to the parent vessel . Aretrospective analysis of 209 aneurysm patients , treated for the last 30 years ( 99 giant and llO large ) was done. Posterior circulatigianton was carrying 230f them , and the anterior circu − lation lesions were 7 / on ICA , 28
more » ... n ACA and 23 on MCA . The acute stage bleeding aneurysms were 64 , chronic or unruptured were 145 . C] ippjng using a combination of fenestrated , angied and straight clips , under short temporary exclusion from circulation ( temporary c1 正 pping or balloon ) , in some cases with suction − decompression of the sac , The presence of a thrombus required 正 ts removal before fjnal clipping . Thick walled aneurysms were cilpped away 丘om the neck to avoid parent vessel stenosis .
doi:10.7887/jcns.15.346_1 fatcat:rlh325emm5dprcaig7r556gx3q