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Journal of Korean Neurosurgical Society > Volume 27(5); 1998 > Article
Journal of Korean Neurosurgical Society 1998;27(5): 672-677.
Prolonged Temporary Arterial Occlusion during Surgery for an Aneurysm of the Dorsal Internal Carotid Artery.
Choong Hyun Kim, Kwoang Hum Bak, Jae Min Kim, Kwang Myung Kim, Nam Kyu Kim
Department of Neurosurgery, College of Medicine, Hanyang University, Seoul, Korea.
The authors describe a case with an uneventful outcome following prolonged temporary arterial occlusion during surgery for an aneurysm of the dorsal internal carotid artery(ICA). It has been shown that in various situations arising during aneurysm surgery, temporary arterial occlusion effectively prevents a premature rupture. It is not possible, however, to predict beforehand what the permissible occlusion time for any individual patient might be. During dissection of a blister aneurysm of the ICA, premature rupture developed, and intermittent temporary occlusion of the ICA, which lasted for about 150 minutes, was then undertaken. In addition, intraoperative neuroprotection was effected in several ways, including intermittent reperfusion and the administration of mannitol, thiopental sodium and steroid. There were no significant postoperative neurological deficits. To the authors' knowledge, this report is unusual in that it documents prolonged temporary occlusion without major neurological sequelae in intracranial aneurysm surgery. Permissible temporary occlusion time and neuroprotective methods are also discussed.
Key Words: Temporary occlusion; Aneurysm; Neuroprotection
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