Serebral Anevrizma Cerrahi Komplikasyonları

Yıl 2011, Cilt: 20 Sayı: 1, 36 - 54, 01.03.2011

Ersin Hacıyakupoğlu Derviş Mansuri Yılmaz Serkan Diril Sabahattin Hacıyakupoğlu

Öz

Serebral anevrizmaların kraniotomi ile klipajı yıllardır kullanılagelen en önemli cerrahi tedavi şeklidir. Cerrahi ekipmanlar ve intraoperatif monitörizasyon tekniklerindeki gelişmeler bu cerrahiyi daha da güvenilir bir hale getirmiştir. Anevrizmayı tamamen kapamaya yönelik cerrahi yeniden kanama riskini anlamlı oranda azaltsa da, intraoperatif ve postoperatif komplikasyonlar hala cerrahi tedavinin faydalarını kısıtlayan önemli faktörlerdir. Beyin cerrahi ekibi hastayı yakından takip etmelidir. Hastaların büyük çoğunluğunda en az bir nörolojik veya cerrahi komplikasyon gelişmektedir, bu nedenle tedavi sonuçlarının iyileştirilebilmesi bu komplikasyonların erkenden teşhis ve tedavisi için sürekli tetikte olmayı gerektirmektedir.

Anahtar Kelimeler

Anevrizma, komplikasyon

Complications of Cerebral Aneurysm Surgery

Öz

Craniotomy and clipping of cerebral aneurysms have been used as most effective surgical treatments for years. Many advances in surgical equipment and intraoperative monitoring methods have resulted in safer and more reliable aneurysm surgery.Surgery to obliterate the aneurysm effectively prevents rebleeding, but intraoperative and postoperative complications are still important factors which are restricting the benefical effects of surgical treatment .Neurosurgical team must continue to monitor the patient closely. The majority of patients will develop at least one neurologic or medical complication, and the optimization of outcome requires ongoing vigilance to facilitate early detection and institutiation of appropriate treatment of complications.

Anahtar Kelimeler

Aneurysm, Complication

Kaynakça

• Batjer HH, Samson SD, Basilar Bifurcation Aneurysms: Neurosurgical Operative Atlas eds: Rengachary SS, Wilkins HR,Willams and Wilkins Baltimore Vol :2: 1992 : pp 283-298. 2. Le Roux DP, Winn RH, Surgical Decision Making for the Treatment of Cerebral Aneurysms: Winn RH Youmans Neurological Surgery Fifth Edition Saunders Philadelphia Vol:2: 2004: pp 1793–1812.
• Zipfel JG, Day LA Surgical Treatment of Paraclinoid Internal Carotid Artery Aneurysms: Batjer HH, Loftus MC Textbook of Neurological Surgery Williams and Wilkins Vol:3:2003: pp: 2372-2381. 4. Samson SP, Kopitnik AT, Surgical Treatment of Aneurysms of the Basilar Artery Bifurcation : Batjer HH, Loftus MC Textbook of Neurological Surgery Williams and Wilkins Vol:3: 2003: pp: 2431-2438.
• Zipfel JG, Day LA, Surgical Treatment of Intracavernous and Paraclinoid Internal Carotid Winn RH Youmans Neurological Surgery Fifth Edition Saunders Philadelphia Vol:2: 2004: pp1895–1914.
• Friedman AJ, Piepgras GD, Middle Cerebral Artery Aneurysms: Winn RH Youmans Neurological Surgery Fifth Edition Saunders Philadelphia Vol:2: 2004: pp1959–1970.
• Day AL, Ophtalmic Segment Aneurysms:Neurosurgical Operative Atlas eds: Rengachary SS, Wilkins HR,Willams and Wilkins Baltimore Vol :2: 1992: pp:25-41.
• Giannotta LS, Levy LM, Carotid Ophthalmic Aneurysms: Branin Surgery ed Apuzzo JLM Churchill Livingstone inc: 1993: pp:944–957. 9. Fukushima T, Day J, Tung H, İntracavernous Carotid Artery Aneurysms : Branin Surgery ed. Apuzzo JLM Churchill Livingstone inc: 1993: pp:925–993.
• Levy LM, Rabb C, Couldwell TW, Zelman V, Apuzzom LJM, Protection of the Neuronal Pool: Branin Surgery ed Apuzzo JLM Churchill Livingstone inc: 1993: pp:857–890.
• Sundt MT, General Overview and Principles of Neurovascular Surgery: Branin Surgery ed Apuzzo JLM Churchill Livingstone inc: 1993: pp:793–824.
• White AJ, Coimbra C, Skull Base Approaches to vascular Lesions : Batjer HH, Loftus MC Textbook of Neurological Surgery Williams and Wilkins Vol:3: 2003 : pp: 2452-2462.
• Selman RW, Taylor LC, Lust DW, Ratcheson AR, Intraoperative Cerebral Protection: Winn RH Youmans Neurological Surgery Fifth Edition Saunders Philadelphia Vol:2: 2004: pp1515–1527.
• Tang G, Cawley MC, Barrow LD, Giant Aneurysms of the Anterior Circulation : Batjer HH, Loftus MC Textbook of Neurological Surgery Williams and Wilkins Vol :3: 2003 : pp: 2452- 2462.
• Newell WD, Lam MA, Transcranial Doppler Ultrasonograph: Winn RH Youmans Neurological Surgery Fifth Edition Saunders Philadelphia Vol:2: 2004: pp1540–1560.
• Al Yamany M, Wallace CM, Intracranial Internal Carotid Artery: Winn RH Youmans Neurological Surgery Fifth Edition Saunders Philadelphia Vol:2: 2004: pp1915–1922.
• Morrison JT, Getch C, Batjer HH, Anterior Communicating Artery Aneurysms: Batjer HH, Loftus MC Textbook of Neurological Surgery Williams and Wilkins Vol:3:2003: pp: 2382– 2396.
• Stiver IS, Surgical Treatment of Middle Cerebral Artery Aneurysms: Batjer HH, Loftus MC Textbook of Neurological Surgery Williams and Wilkins Vol : 3: 2003: pp: 2402–2414.
• Tamargo JR, Haroun IR, Rigamonti D, Anterior Communicating Artery and Anterior Cerebral Artery Aneurysms Winn RH Youmans Neurological Surgery Fifth Edition Saunders Philadelphia Vol:2: 2004: pp1923–1944.
• Tox LJ, Sengupta PR, Anterior Communicating Artery Coplex Aneurysms: Branin Surgery ed Apuzzo JLM Churchill Livingstone inc: 1993: pp:1009–1034.
• Le Roux DP, Winn RH, Surgical Decision Making for the Treatment of Cerebral Aneurysms: Winn RH Youmans Neurological Surgery Fifth Edition Saunders Philadelphia Vol:2: 2004: pp 1793–1812.
• Aydın IH, Tüzün Y, Tarakçı E, The Anatomical Variotions of Sylvian Veins and Cistern. Minim Invas Neurosurg:40:1997:67–73.
• Yaşargil MG, Middle Cerebral Artery Aneurysms. In: Yaşargil MG (eds). Microneurosurgery. Vol:2:New York. Thieme: 1984:124–164.
• Pikus JH, Surgical Treatment of Middle Vertebral and Posterior Inferior Cerebellar Artery Aneurysms: Batjer HH, Loftus MC Textbook of Neurological Surgery Williams and Wilkins Vol:3: 2003: pp: 2415–2420.
• Lawton TM, Vates EG, Spetzler FR, Surgical Approaches for Posterior Circulation Aneurysms: Winn RH Youmans Neurological Surgery Fifth Edition Saunders Philadelphia Vol:2: 2004: pp1971–2006.
• Lavine DS, Day DJ, Albuquerque CF, Giannotta LS,Basilar Trunk Aneurysms : Winn RH Youmans Neurological Surgery Fifth Edition Saunders Philadelphia Vol:2: 2004: pp2025– 2040.
• Bendok RB, Ali JM,Getch CC, Batjer HH: Basilar Apex and Posterior Cerebral Artery Aneurysms : Winn RH Youmans Neurological Surgery Fifth Edition Saunders Philadelphia Vol:2: 2004: pp2041–2056.
• Övül İ, Basiler Tepe ve Posterior Sirkülasyon Anevrizma Cerrahisi: Türkiye Klinikleri Vol: 2: No:16: 2006: 70–76.
• Droke GC, Basilar Artery Bifurcation Aneurysms: Branin Surgery ed Apuzzo JLM Churchill Livingstone inc: 1993: pp:1041–1047.
• Lemole MG, Henn SJ, Spetzler FR, Rina AH, Giant Aneurysms : Winn RH Youmans Neurological Surgery Fifth Edition Saunders Philadelphia Vol:2: 2004: pp:2079–2100.
• Batjer HH, Samson SD: Basilar Apex Aneurysms: Branin Surgery ed. Apuzzo JLM Churchill Livingstone inc: 1993: pp:1048–1082.
• Diepgras GD, Posterior Cerebral and Superior Cerebellar Artery Aneurysms: Branin Surgery ed. Apuzzo JLM Churchill Livingstone inc: 1993: pp:1083–1100.
• Hacıyakupoğlu S, Serebral Vasospasm: Türkiye Klinikleri Vol:2 No:16: 2006: 21–37.
• Findlay MJ, Cerebral Vasospasm: Winn RH Youmans Neurological Surgery Fifth Edition Saunders Philadelphia Vol: 2: 2004: pp1839–1867.
• Jakobson E, Ender G, Zygmunt S, et al. Intraoperative Complication in Aneurysm Surgery. J Neurosurg: 96: 2002: 510–514.
• Özyurteri E, Serebro Vasküler Hastalıklarda Radyolojik Tanı ve Tedavi: Türkiye Klinikleri Vol:2 No:16: 2006: 6–9.
• Hosoda K, Fujita S, Kawaguchi T, Saccular Aneueysm of the Proximal Segment of Middile Cerebral Artery: Neurosurgery:36:1995:441–446.
• Pzzafi E, Nazzo G, Garot G. Gaint Aneurysms of Pericallosal Artery. J Neurosurg:57: 1982: 566–569.
• Treggiari MM, Walder B, Sater MP, et al. Systematic review of the Prevention of delayed Ischemic Neurological Deficit With Hypertension Hypervolemic and Hemodilution Therapy Following Subaracnoid Hemorrhage. J. Neurosurg: 98: 2003: 978–984.
• Kassel FN, Shatfreg EM, Shatfreg IC, Cerebral Vasospasm Following Subarachnoid Hemorrhage: Branin Surgery ed Apuzzo JLM, Churchill Livingstone inc: 1993: pp:847–856.
• Ballock RM. Hyperoxia: Good or Bad. J. Neurosurg:98:2003:943–944.
• Weir KB, Findlay MJ, Dishey L, Middle Cerebral Artery Aneurysms: Branin Surgery ed Apuzzo JLM Churchill Livingstone inc: 1993: pp:983–1008.