Kinked Perforator Due to Clipping of Parent Vessel Aneurysm: Technical Note and Lessons Learned

World Neurosurg. 2019 Aug:128:473-476. doi: 10.1016/j.wneu.2019.05.131. Epub 2019 May 24.

Abstract

Background: Adverse outcomes after aneurysm clipping can be potentially reversible, when managed appropriately.

Methods: This is a case report describing kinking of a perforator due to clipping of parent vessel aneurysm.

Results: Complete recovery of a high-grade motor deficit was achieved after instant reintervention with application of smaller clips in combination with gelfoam soaked in papaverine.

Conclusion: Use of evoked potentials and intraoperative digital subtraction angiography are recommended and may help in preclinical diagnosis. Knowledge of delayed perforator kinking as a complication may lead to a more rapid diagnosis and management.

Keywords: Clipping; Kinked; Perforator.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angiography, Digital Subtraction
  • Cerebral Angiography
  • Craniotomy
  • Evoked Potentials
  • Humans
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Cerebral Artery / surgery*
  • Neurosurgical Procedures
  • Paresis / etiology
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery*
  • Reoperation
  • Surgical Instruments / adverse effects*