Abstract
Paraclinoid aneurysms originate from the internal carotid artery between the distal
dural ring and the posterior communicating artery. Giant, multiple and bilateral aneurysms
are more frequent in this group of aneurysms. Surgical clipping of these aneurysms
is technically challenging due to the adjacent bony anatomy and neurovascular structures.
Operative mortality has been reduced substantially due to advances in microsurgical
techniques. However, there is still no uniformity with respect to the surgical procedures
used, especially regarding the use of skull-base approaches and resection of the anterior
clinoid process. Due to the complexity of these aneurysms, endovascular procedures
are used frequently to treat these aneurysms. We have reviewed the anatomical, radiological
aspects and classification of paraclinoid aneurysms. Surgical and endovascular management
options are also reviewed.
Keywords
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Article info
Publication history
Accepted:
June 20,
2010
Received:
April 6,
2010
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Published by Elsevier Inc.
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- Commentary: Paraclinoid carotid aneurysmsJournal of Clinical NeuroscienceVol. 18Issue 1
- PreviewJavalkar et al.,1 in this issue of the Journal of Clinical Neuroscience, have provided an excellent analysis of the current thinking regarding management of paraclinoid aneurysms and ophthalmic aneurysms, by both endovascular and surgical techniques. However, this comprehensive analysis and classification, in my view, overcomplicates the treatment of these aneurysms and may create fear that these aneurysms are of such complexity that they should be always considered first for endovascular repair.
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