Interhemispheric Approach for Clipping of a Pericallosal Artery Aneurysm: 2-Dimensional Operative Video

Authors

Anmol Nagaraj, Department of Neurosurgery, Rutgers, Robert Wood Johnson Medical School & University Hospital, New Brunswick, New Jersey, USA.
Neil Majmundar, Department of Neurosurgery, Rutgers, Robert Wood Johnson Medical School & University Hospital, New Brunswick, New Jersey, USA.Follow
Fareed Jumah, Department of Neurosurgery, Rutgers, Robert Wood Johnson Medical School & University Hospital, New Brunswick, New Jersey, USA.
Bharath Raju, Department of Neurosurgery, Rutgers, Robert Wood Johnson Medical School & University Hospital, New Brunswick, New Jersey, USA.
Anil Nanda, Department of Neurosurgery, Rutgers, Robert Wood Johnson Medical School & University Hospital, New Brunswick, New Jersey, USA. Electronic address: an651@rwjms.rutgers.edu.

Document Type

Article

Abstract

Pericallosal artery aneurysms are rare, accounting for 2%-9% of all intracranial aneurysms. They are most commonly saccular and wide necked. Although typically small, they are more prone to rupture compared with other aneurysms in the anterior circulation. They are more common in people with unpaired or azygous arteries. Rupture of pericallosal artery aneurysm results in intracerebral hematoma in approximately 50% of patients, usually in the frontal lobe, anterior interhemispheric fissure, pericallosal cistern, or cingulate gyrus. Compared with other supratentorial aneurysms, surgical clipping of pericallosal aneurysms carries a higher morbidity and mortality. A 47-year-old female presented with sudden-onset worst headache of her life followed by dizziness, syncope, transient weakness, and numbness over the left lower extremity. She was neurologically intact, and imaging revealed a right pericallosal artery aneurysm. The patient consented to the procedure. The 2-dimensional Video 1 demonstrates the interhemispheric approach for clipping of a pericallosal artery aneurysm. These aneurysms are approached in the distal-to-proximal direction along with the distal anterior cerebral artery. Meticulous dissection avoids rupture without proximal control. We highlight the key surgical steps and microsurgical techniques in approaching these aneurysms. The patient tolerated the operation well with an uneventful postoperative course.

Medical Subject Headings

Anterior Cerebral Artery (diagnostic imaging, surgery); Arteries; Brachiocephalic Trunk; Dissection; Female; Humans; Intracranial Aneurysm (diagnostic imaging, surgery); Middle Aged

Publication Date

5-1-2022

Publication Title

World neurosurgery

E-ISSN

1878-8769

Volume

161

First Page

90

PubMed ID

35114408

Digital Object Identifier (DOI)

10.1016/j.wneu.2022.01.093

Recommended Citation

Nagaraj, Anmol; Majmundar, Neil; Jumah, Fareed; Raju, Bharath; and Nanda, Anil, "Interhemispheric Approach for Clipping of a Pericallosal Artery Aneurysm: 2-Dimensional Operative Video" (2022). Neurosurgery. 2206.
https://scholar.barrowneuro.org/neurosurgery/2206