Journal
WORLD NEUROSURGERY
Volume 126, Issue -, Pages 537-540Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.wneu.2019.02.128
Keywords
Artery rupture; Calcified; Craniopharyngioma; Transsphenoidal approach
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Funding
- National Natural Science Foundation of China [81502148, 81874082]
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BACKGROUND: This report discusses the risks and complications of using the extended endoscopic endonasal transsphenoidal approach (EEETA) in a special craniopharyngioma case to caution neurosurgeons. CASE DESCRIPTION: A 38-year-old woman with craniopharyngioma underwent EEETA surgery. Her anterior cerebral artery was punctured intraoperatively and clipped using an aneurysm clip through the nose in an emergency procedure. CONCLUSIONS: The coexistence of severe calcified craniopharyngiomas, especially with sharp calcified spurs, a narrow distance between the anterior communicating artery and the planum sphenoidale, and a narrow distance between the bilateral internal carotid arteries is a significant warning signal during EEETA for craniopharyngiomas. In this circumstance, it may be preferable to use open microsurgical approaches. If the anterior communicating artery or anterior cerebral artery is punctured during EEETA, another method is available to fix the problem using an aneurysm clip through the nose, and not only endovascular embolization.
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