• World Neurosurg · Jun 2019

    Case Reports

    Anterior cerebral artery rupture during extended endoscopic endonasal transsphenoidal approach for severely calcified craniopharyngioma.

    • Chuanwei Wang, Yulin Zhang, Jiangang Wang, and Shilei Ni.
    • Department of Neurosurgery, Qilu Hospital of Shandong University and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong Province, China; Shandong Key Laboratory of Brain Function Remodeling, Jinan, Shandong Province, China.
    • World Neurosurg. 2019 Jun 1; 126: 537-540.

    BackgroundThis report discusses the risks and complications of using the extended endoscopic endonasal transsphenoidal approach (EEETA) in a special craniopharyngioma case to caution neurosurgeons.Case DescriptionA 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.ConclusionsThe 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.Copyright © 2019 Elsevier Inc. All rights reserved.

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