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Trallmatic Intracranial Aneurysms after Removal of Tuberculum Sella Meningioma:Case report Ryoichi SAITO 1 , Takahito YAZAKI 1 , Takeshi KAWASE 1 , Shigeo TOYA 1 1Department of Neuro-surgery, School of Medicine, Keio University Keyword: Traumatic aneurysm , Meningioma pp.973-977
Published Date 1992/9/10
DOI https://doi.org/10.11477/mf.1436900522
  • Abstract
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Two cases of traumatic aneurysms (TA) of the inter-nal carotid artery (IC) due to removal of tuberculum sellae meningioMa (TSM) are presented, and ideal treatment of those aneurysms is discussed.

The tumor, compressing the IC laterally, was re-moved Out without arterial injury in case 1. Though the patient's postoperative course was uneventful, frontal and intraventricular hemorrhage developed 2 months after the operation, and an IC dorsal aneurysm was de-tected. Preoperative angiograms showed no aneurysm, so it was considered to be a traumatic aneurysm clue to the surgical procedure. The aneurysm was clipped at once, but postoperative angiograms showed recurrence of the aneurysm. IC balloon occlusion was carried out as the Matas test was negative. In case 2, a small tear in the IC was inadvertently made during recurrent TSM removal, which was wrapped with muscle using fibrin glue. 2 weeks after the operation, frontal hemor-rhage developed. Angiograms revealed a small aneurysm of the IC, which was considered to be a traumatic aneurysm. IC balloon occlusion was per-formed as the Matas test was negative. These 2 pa-tients have had no episodes of rerupture after the IC balloon occlusion.

Tumors and main arteries are frequently adhesive, so arteries are easily injured during removal of mening-iomas. Muscle wrapping was not enough to prevent TA formation. Neck clipping was not appropriate for treat-ment of TA, but IC balloon occlusion was an effective and excellent therapy for TA of IC.


Copyright © 1992, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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