PMC4274853_01
Magnetic resonance without any abnormality.
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She is a chronic smoker and was investigated through computed tomography (CT), brain magnetic resonance imaging (Figure 2), angiotomography (Figure 3), and cerebral angiography.
Angiotomography shows a P2P aneurysm of the right side (yellow target).
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fig3
She is a chronic smoker and was investigated through computed tomography (CT), brain magnetic resonance imaging (Figure 2), angiotomography (Figure 3), and cerebral angiography.
Positioning the patient with Mayfield surgical frame to subtemporal approach.
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The patient was positioned with Mayfield surgical frame and submitted to a subtemporal approach (Figure 4).
Detaching and mobilizing the anterior temporal lobe open the operative corridor through the carotid-oculomotor triangle.
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fig5
Superficial dissection strategy for P2P aneurysm was done by detaching and mobilizing the anterior temporal lobe opening the operative corridor through the carotid-oculomotor triangle (Figure 5).
Visualization of the P2P segment aneurysm.
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Dissecting the P2 segment was necessary laterally over the oculomotor nerve to the tentorial edge (Figure 6).
Definitive clipping of the aneurysm.
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With a dissection of the neck of the aneurysm a definitive Sugita clip (Mizuho, Japan) was placed (Figure 7).
A postoperative CT scan.
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After the surgery a CT scan was performed (Figure 8).
Patient 3 days after the surgery.
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fig9
Patient showed a good postoperative evolution without neurologic deficits (Figure 9).