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Clinical case of unruptured giant aneurysm with therapeutic success
Author(s): ,
G. Januário
Affiliations:
Centro Hospitalar Lisboa Central, Hospital de São José, Neurosurgery, Lisbon, Portugal
,
P. Branco
Affiliations:
Centro Hospitalar Lisboa Central, Hospital de São José, Neurosurgery, Lisbon, Portugal
,
A. Sagarribay
Affiliations:
Centro Hospitalar Lisboa Central, Hospital de São José, Neurosurgery, Lisbon, Portugal
C. Vara Luiz
Affiliations:
Centro Hospitalar Lisboa Central, Hospital de São José, Neurosurgery, Lisbon, Portugal
EANS Academy. Janu‡rio G. Oct 21, 2018; 225758; EP1049
Gon�alo Janu‡rio
Gon�alo Janu‡rio
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Abstract
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Background:

Large and giant aneurysms typically involve cavernous and paraclinoid segments of the internal carotid artery. They represent 5% of intracranial aneurysms. Morphologically they are divided into two types, saccular and fusiform. Often patients present with symptoms related to the mass effect caused by the aneurysm in the intracranial nerves.
The aim of treatment, regardless of the technique used, is to preserve the function of the structures involved.


Methods:

The authors describe the clinical case of a 55-year-old, female, with a personal history of hypertension, hyperthyroidism and depressive syndrome. The patient started complaints of moderate-intensity right frontal headache, progressively worsening. He also reported blurred vision and diplopia. She performed a CT scan that documented a partial calcified seal and parasellar lesion. Later, he underwent RMI and MRI angiography showing saccular aneurysm of the right ICA, cavernous segment.


Results:

The patient underwent therapeutic angiography after 10 days of double antiaggregation with stent placement, flow-diverter. She presented clinical and imagiologic improvement documented by angiography with progressive reduction of the aneurysm dimension.


Conclusions:

The aim of the treatment of this pathology is to exclude the lesion of the circulation, preserving the function of the surrounding neurological structures.A multidisciplinary approach is recommended for the selection of the most appropriate therapeutic option in each case, microsurgical or endovascular techniques.The evolution of the microsurgical and endovascular techniques is fundamental to improve the therapeutic results of this pathology.
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