Visual outcomes after surgery for paraclinoid aneurysms: A fujita experience

Raja Kutty; Ambuj Kumar; Yasuhiro Yamada; Tsukosa Kawase; Riki Tanaka; Kyosuke Miyatani; Saeko Higashiguchi; Vigneswar Ravishankar; Katsumi Takizawa; Yoko Kato

doi:10.4103/ajns.AJNS_39_20

Asian Journal of Neurosurgery, Table of Contents

CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(02): 363-369
DOI: 10.4103/ajns.AJNS_39_20

Original Article

Visual outcomes after surgery for paraclinoid aneurysms: A fujita experience

Authors

Raja Kutty

Department of Neurosurgery, Government Medical College, Trivandrum, Kerala
Ambuj Kumar

¹Department of Neurosurgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh
Yasuhiro Yamada

²Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Otobashi, Nagoya
Tsukosa Kawase

²Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Otobashi, Nagoya
Riki Tanaka

²Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Otobashi, Nagoya
Kyosuke Miyatani

³Department of Neurosurgery, Banbuntane Hotokukai Hospital, Otobashi, Nagoya
Saeko Higashiguchi

³Department of Neurosurgery, Banbuntane Hotokukai Hospital, Otobashi, Nagoya
Vigneswar Ravishankar

⁴Department of Neurosurgery, Institute of Neurosciences and Spinal Disorders, MGM Healthcare, Chennai, Tamil Nadu
Katsumi Takizawa

⁵Department of Neurosurgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Hokkaido
Yoko Kato

³Department of Neurosurgery, Banbuntane Hotokukai Hospital, Otobashi, Nagoya

Abstract

Introduction: The surgical strategies for clipping of paraclinoid aneurysms are diverse. These aneurysms are unique in their location, as they closely abut the anterior clinoid process (ACP) and the optic nerve. The ultimate goal of clipping encompasses the exposure of neck of the aneurysm which is seldom complete without the manipulation of optic nerve and the ACP. This manipulation may result in disturbances of vision postoperatively. We analyze our results of visual outcomes in the surgery for paraclinoid aneurysms in this retrospective study. Materials and Methods: All patients with paraclinoid aneurysms who underwent surgery from June 2014 to June 2019 were included in the study. Surgical procedure was uniform in all patients which included anterior clinoidectomy and clipping of aneurysms as per the Bantane protocol. Glasgow Outcome Scale as well as vision was assessed at discharge and at 1 month and 6 months. Results: There were 77 cases of paraclinoid aneurysms operated during the abovementioned period. All patients had no symptoms related to vision preoperatively. Visual deterioration was noted in two patients. All patients were discharged with a good outcome on the Glasgow Outcome Scale. Conclusion: Paraclinoid aneurysm has a good outcome when treated with surgery. The visual deterioration following surgery can be minimized with extradural anterior clinoidectomy and careful handling of the vessels and nerve.

Key-words:

Clipping - paraclinoid aneurysms - visual outcomes

Full Text

References

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