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J Neurol Surg B Skull Base 2018; 79(05): 427-436
DOI: 10.1055/s-0037-1615804
Original Article
Georg Thieme Verlag KG Stuttgart · New York

The Microsurgical Relationships between Internal Carotid-Posterior Communicating Artery Aneurysms and the Skull Base

Satoshi Matsuo
1   Department of Neurosurgery, Kyushu Central Hospital, Fukuoka, Japan
2   Department of Neurosurgery, Clinical Research Institute, Kyushu Medical Center, National Hospital Organization, Fukuoka, Japan
,
Noritaka Komune
3   Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
,
Ryosuke Tsuchimochi
1   Department of Neurosurgery, Kyushu Central Hospital, Fukuoka, Japan
,
Yasutoshi Kai
4   Department of Neurosurgery, Iizuka Hospital, Fukuoka, Japan
,
Kenichi Matsumoto
5   Department of Neurosurgery, Saga Medical Center Koseikan, Saga, Japan
,
Sei Haga
6   Department of Neurosurgery, Kyushu Rosai Hospital, Fukuoka, Japan
,
Takuya Inoue
1   Department of Neurosurgery, Kyushu Central Hospital, Fukuoka, Japan
› Author Affiliations
Further Information

Publication History

08 July 2017

19 November 2017

Publication Date:
29 December 2017 (online)

Also available atMedOne
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Abstract

Objective This study aimed to review the anatomical and clinical characteristics of internal carotid-posterior communicating artery (IC-PC) aneurysms, especially those located close to the skull base.

Methods The microsurgical anatomy around the posterior communicating artery (PComA) was examined in a dry skull and five formalin-fixed human cadaveric heads. The clinical characteristics of 37 patients with 39 IC-PC aneurysms, who were treated microsurgically between April 2008 and July 2016, were retrospectively reviewed.

Results The anterior clinoid process (ACP), as well as the anterior petroclinoidal dural fold (APF), which forms part of the oculomotor triangle, are closely related to the origin of the PComA. Among the 39 IC-PC aneurysms, anterior clinoidectomy was performed on 4 (10.3%) and a partial resection of the APF was performed on 2 (5.1%). Both of these aneurysms projected inferior to the tentorium, or at least part of the aneurysm's dome was inferior to the tentorium.

Conclusion Proximally located IC-PC aneurysms have an especially close relationship with the ACP and APF. We should be familiar with the anatomical relationship between IC-PC aneurysms and the structures of the skull base to avoid hazardous complications.

Keywords

anterior clinoid process - anterior petroclinoidal dural fold - internal carotid artery - posterior communicating artery - skull base

Disclosure

The authors have no personal financial or institutional interest in any of the materials or devices described in this article. Part of this work was supported by the University of Florida Foundation.