Kinked Perforator Due to Clipping of Parent Vessel Aneurysm: Technical Note and Lessons Learned.

Van Der Veken, Jorn; Mulcahy, Michael J; Harrington, Timothy J; Assaad, Nazih N · World Neurosurg · 2019

case_report · Level V

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Abstract

Adverse outcomes after aneurysm clipping can be potentially reversible, when managed appropriately. This is a case report describing kinking of a perforator due to clipping of parent vessel aneurysm. Complete recovery of a high-grade motor deficit was achieved after instant reintervention with application of smaller clips in combination with gelfoam soaked in papaverine. Use of evoked potentials and intraoperative digital subtraction angiography are recommended and may help in preclinical diagnosis. Knowledge of delayed perforator kinking as a complication may lead to a more rapid diagnosis and management.

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