Abordaje temporopolar para la cirugía de aneurismas intracraneales de la circulación posterior. Informe de 2 casos.
Abstract
Los aneurismas intracraneales de la circulación posterior representan un reto para la neurocirugía contemporánea y para la neurorradiología intervencionista, debido a la complejidad anatómica de su topografía que predispone a la aparición de complicaciones. La oclusión endovascular representa la opción más acertada para el tratamiento de estas lesiones, pero al no existir una cobertura adecuada para todos los pacientes, la microcirugía representa una alternativa para el manejo de los pacientes con esta compleja enfermedad. En el presente trabajo se presentan dos casos intervenidos quirúrgicamente, uno con un aneurisma del tope de la basilar y otro con uno de la arteria cerebelosa superior izquierda, en los que se utilizó un abordaje temporopolar descrito por Sano, con resultados satisfactorios. Se concluye que este abordaje representa una alternativa adecuada al resto de las técnicas usadas para el tratamiento quirúrgico de estas lesiones.Downloads
References
Bederson JB, Connolly ES, Batjer HH, Dacey RG, Dion JE, Diringer MN, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage. A statement for healthcare professionals from a special writing group of the stroke council, American Heart Association. Stroke. 2009; 40:1-33.
Ingall T, Asplund K, Mahonen M, Bonita R. A multinational comparison of subarachnoid hemorrhage epidemiology in the WHO MONICA stroke study. Stroke. 2000; 31:1054 –61.
Inagawa T, Takechi A, Yahara K, Saito J, Moritake K, Kobayashi S et al. Primary intracerebral and aneurysmal subarachnoid hemorrhage in Izumo City, Japan, part I: incidence and seasonal and diurnal variations. J Neurosurg 2000; 93: 958–66.
Rhoton AL. Aneurysms. Neurosurgery. 2002; 51 (Suppl.1): 51-121.
Drake CG. Bleeding aneurysm of the basilar artery: direct surgical management in four cases. J Neurosurg. 1961; 18: 230-8.
Yasargil MG, Antic J, Lacigar R, Jain KK, Hodosh RM, Smith RD. Microsurgical pterional approach to aneurysms of the basilar bifurcation. Surg Neurol 1976; 6: 83-91.
Sano K. Temporo-polar approach to aneurysms of the basilar artery at and around the distal bifurcation: technical note. Neurol Res. 1980; 2: 361-7.
Sano K. Surgical techniques: vertebra-basilar aneurysms. In: Sano K, Asano T, Tamura A (eds). Acute aneurysm surgery. Pathophysiology and management. Springer, Wien New York. 1987: 223-46.
Sano K, Shiokawa Y. The temporo-polar approach to basilar artery aneurysms with or without zygomatic arch translocation. Acta Neurochir 1994; 130: 14-19.
Figueiredo EG, Tavares WM, Rhoton AL Jr, de Oliveira E. Nuances and technique of the pretemporal transcavernous approach to treat low-lying basilar artery aneurysms. Neurosurg Rev. 2010; 33:129–35.
Wang J, Sun Z, Bao J, Zhang B, Jiang Y, Lan W. Characteristics and endovascular treatment of aneurysms of posterior cerebral artery. Neurol India 2011; 59:6-11.
Gruber DP, Zimmerman GA, Tomsick TA, van Loveren HR, Link MJ, Tew JM Jr. A comparison between endovascular and surgical man-agement of basilar artery apex aneurysms. J Neurosurg. 1999; 90: 868–87.
Li Y, Lv X, Jiang C, Liu A, Wu Z. Endovascular treatment of posterior cerebral artery aneurysms. Neuroradiol J. 2008; 21: 128-36.
Conway JE, Raza SM, Li K, McDermott MW, Quiñones-Hinojosa A. A surgical modification for performing orbitozygomatic osteotomies: technical note. Neurosurg Rev. 2010;
Tanriover N, Ulm AJ, Rhoton AL Jr, Kawashima M, Yoshioka N, Lewis SB. One-piece versus two-piece orbitozygomatic craniotomy: quantitative and qualitative considerations. Neurosurgery. 2006; 58: 229–37.
Downloads
Published
How to Cite
Issue
Section
License
Those authors who have publications with this journal accept the following terms of the License CC Attribution-NonCommercial 4.0 International (CC BY-NC 4.0):
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
The journal is not responsible for the opinions and concepts expressed in the works, which are the exclusive responsibility of the authors. The Editor, with the assistance of the Editorial Committee, reserves the right to suggest or request advisable or necessary modifications. Original scientific works are accepted for publication, as are the results of research of interest that have not been published or sent to another journal for the same purpose.
The mention of trademarks of specific equipment, instruments or materials is for identification purposes, and there is no promotional commitment in relation to them, neither by the authors nor by the editor.

















