scholarly journals Use of Microvascular Doppler Sonography in Aneurysm Surgery on the Anterior Choroidal Artery.

2000 ◽  
Vol 40 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Yuuji SHIBATA ◽  
Shigekiyo FUJITA ◽  
Tetsuro KAWAGUCHI ◽  
Kohkichi HOSODA ◽  
Hideki KOMATSU ◽  
...  
Keyword(s):  
Doppler Sonography ◽  
Anterior Choroidal Artery ◽  
Aneurysm Surgery ◽  
Anterior Choroidal ◽  
Choroidal Artery ◽  
Microvascular Doppler Sonography

Intraoperative monitoring of blood flow insufficiency in the anterior choroidal artery during aneurysm surgery

2003 ◽  
Vol 98 (3) ◽  
pp. 507-514 ◽  
Author(s):  
Kyouichi Suzuki ◽  
Namio Kodama ◽  
Tatsuya Sasaki ◽  
Masato Matsumoto ◽  
Yutaka Konno ◽  
...  
Keyword(s):  
Blood Flow ◽  
Motor Cortex ◽  
Intensity Level ◽  
Anterior Choroidal Artery ◽  
Aneurysm Surgery ◽  
Monitoring Method ◽  
Content Type ◽  
Anterior Choroidal ◽  
Choroidal Artery ◽  
Fine Print

Object. The lack of a specified intraoperative method for monitoring anterior choroidal artery (AChA) blood flow insufficiency (BFI) led the authors to devise a method for checking the BFI in this artery during aneurysm surgery. To this end, the authors relied on the intraoperative motor evoked potentials (MEPs) elicited by electrical stimulation of the hand motor cortex. Methods. The study population consisted of 108 patients with internal carotid artery (ICA) aneurysms who underwent surgery via a standard frontotemporal craniotomy. After the dura mater had been opened, a grid electrode strip with 16 small electrodes was inserted subdurally into the hand motor cortex from the edge of the craniotomy. To check BFI in the AChA, the hand motor cortex was stimulated at an intensity level between 10 and 18 mA. The MEPs were successfully recorded from the contralateral thenar muscles in all 108 patients. There was no postoperative motor paresis in 88 patients in whom the MEPs remained unchanged during the performance of various surgical maneuvers. Among the other 20 patients, 19 manifested transient MEP changes, but 15 of those patients experienced no postoperative motor paresis. In four patients who exhibited transient MEP changes, either after aneurysm clipping or during temporary occlusion of the ICA and/or AChA, hemiparesis occurred postoperatively but disappeared within 24 hours. In one patient with an ICA—posterior communicating artery aneurysm, the MEP disappeared and did not reappear by the time of dural closure. Severe hemiplegia developed in this patient and a computerized tomography scan obtained postoperatively revealed a new low-density area in the internal capsule. Conclusions. The findings of this study suggest that the monitoring method that is introduced here is safe and reliable for detecting intraoperative BFI in the AChA.

The anterior choroidal artery

1978 ◽  
Vol 14 (2) ◽  
pp. 160
Author(s):  
SY Rho ◽  
SH Cha ◽  
WH Lee ◽  
JS Kim
Keyword(s):  
Anterior Choroidal Artery ◽  
Anterior Choroidal ◽  
Choroidal Artery

scholarly journals Paracentral homonymous hemianopic scotoma caused by anterior choroidal artery infarction

QJM ◽  
2021 ◽  
Author(s):  
A Mitsutake ◽  
Y Nagashima ◽  
H Mori ◽  
H Sawamura ◽  
T Toda
Keyword(s):  
Anterior Choroidal Artery ◽  
Anterior Choroidal ◽  
Choroidal Artery

Management of an Uncommon Complication: Anterior Choroidal Artery Occlusion by Posterior Clinoid Process Detected Through Intraoperative Monitoring After Clipping of Paraclinoid Aneurysm: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Walter Marani ◽  
Francisco Mannará ◽  
Kosumo Noda ◽  
Tomomasa Kondo ◽  
Nakao Ota ◽  
...  
Keyword(s):  
Intraoperative Monitoring ◽  
Motor Evoked Potential ◽  
Japanese Woman ◽  
Motor Deficits ◽  
Anterior Choroidal Artery ◽  
Diffusion Weighted Images ◽  
Ct Angiogram ◽  
Paraclinoid Aneurysms ◽  
Anterior Choroidal ◽  
Choroidal Artery

Abstract Despite technological advances in endovascular therapy, surgical clipping of paraclinoid aneurysms remains an indispensable treatment option and has an acceptable profile risk. Intraoperative monitoring of motor and somatosensory evoked potentials has proven to be an effective tool in predicting and preventing postoperative motor deficits during aneurysm clipping.1,2 We describe the case of a 61-yr-old Japanese woman with a history of hypertension and smoking. During follow-up for bilateral aneurysms of ophthalmic segment of the internal carotid artery (ICA), left-sided aneurysm growth was detected. A standard pterional approach with extradural clinoidectomy was used to approach the aneurysm. After clipping, a significant intraprocedural change in motor evoked potential (MEP) amplitude was observed despite native vessel patency was confirmed through micro-Doppler and indocyanine green video angiography.3-5 After extensive dissection of the sylvian fissure and exposure of the communicating segment of ICA, the anterior choroidal artery was found to be compressed and occluded by the posterior clinoid because of an inadvertent shift of the ICA after clip application and removal of brain retractors. Posterior clinoidectomy was performed intradurally with microrongeur and MEP amplitude returned readily to baseline values. Computed tomography (CT) angiogram demonstrated complete exclusion of the aneurysm, and magnetic resonance imaging (MRI) was negative for postoperative ischemic lesions on diffusion weighted images. The patient tolerated the procedure well and was discharged home on postoperative day 3 with modified Rankin Scale (mRS) 0. The patient signed the Institutional Consent Form to undergo the surgical procedure and to allow the use of her images and videos for any type of medical publications.

scholarly journals A Case of Anterior Choroidal Artery Occlusion and Stroke Secondary to External Compression

2021 ◽  
pp. 369-374
Author(s):  
Satya Narayana Patro ◽  
Khawaja Hassan Haroon ◽  
Khansabegum Tamboli ◽  
Abdulaziz Zafar ◽  
Suhail Hussain ◽  
...  
Keyword(s):  
Medial Temporal Lobe ◽  
Optic Tract ◽  
Internal Capsule ◽  
Cerebral Peduncle ◽  
Anterior Choroidal Artery ◽  
Vessel Occlusion ◽  
External Compression ◽  
Posterior Limb ◽  
Anterior Choroidal ◽  
Choroidal Artery

The anterior choroidal artery (AChA) is a small artery commonly arising from the supraclinoid segment of the internal carotid artery (ICA). The significance of the AChA is related to its strategic supply to various important structures of the brain, such as the optic tract, the posterior limb of the internal capsule, the cerebral peduncle, the lateral geniculate body, medial temporal lobe, medial area of pallidum, and the choroid plexus [<i>J Neurol</i>. 1988;235:387–91]. The AChA syndrome in its complete form consists of the triad of hemiplegia, hemisensory loss, and hemianopia. However, incomplete forms are more frequent in clinical practice [<i>Stroke</i>. 1994;25:837–42]. Isolated infarction in the AChA territory is relatively rare. The presumed pathogenic mechanisms of AChA infarction are cardiac emboli, large-vessel atherosclerosis, dissection of the ICA, small-vessel occlusion, or other determined or undetermined causes [<i>Stroke</i>. 1994;25:837–42 and <i>J Neurol Sci</i>. 2009;281:80–4].

The Perforating Branches of the Internal Carotid Artery: The Microsurgical Anatomy of Their Extracerebral Segments

Neurosurgery ◽  
1990 ◽  
Vol 26 (3) ◽  
pp. 472-479 ◽  
Author(s):  
Slobodan V. Marinkovié ◽  
Milan M. Milisavljevié ◽  
Zorica D. Marinkovié
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Cerebral Aneurysms ◽  
Microsurgical Anatomy ◽  
Great Care ◽  
Anterior Choroidal Artery ◽  
Frequent Site ◽  
Anterior Choroidal ◽  
Choroidal Artery

Abstract The perforating branches of the internal carotid artery (ICA) were examined in 30 forebrain hemispheres. These branches were present in all the cases studied, and varied from 1 to 6 in number (mean, 3.1). Their diameters ranged from 70 to 470 Mm (mean, 243 Mm). The perforating branches arose from the choroidal segment of the ICA, that is, from its caudal surface (52.3%), caudolateral surface (34.1%), or caudomedial surface (13.6%). They rarely originated from the bifurcation point of the ICA (10%). The distance of the remaining 90% of the perforators from the summit of the ICA measured between 0.6 and 4.6 mm. The perforating branches most often originated as individual vessels, and less frequently from a common stem with another vessel or by sharing the same origin site with another perforator or with the anterior choroidal artery. The bifurcation of the ICA, which is a frequent site for cerebral aneurysms, is surrounded by many perforating branches. Hence, great care must be taken to avoid damage to these important vessels during operations in that region.

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