Microsurgical management of XXXX of the @entity76 - lessons learnt: An experience of 14 consecutive cases and review of the literature.

@entity1 @entity1276 @entity510 @entity438 @entity2895 @entity439 @entity76 @entity2553 @entity1756
OBJECTIVE: This is a retrospective study from January 2002 to December 2012 analyzing the results of microsurgical clipping for @entity439 arising from the @entity76 ( @entity76 ). MATERIALS AND METHODS: All @entity1 with @entity76 were evaluated with computerized tomography angiography and/or digital subtraction angiography (DSA) prior to surgery. All @entity1 in our series underwent microsurgical clipping and postoperative DSA to assess the extent of @entity439 . The Glasgow outcome scale (GOS) and the modified Rankin's scale (mRS) were used to grade their postoperative neurological status at discharge and 6 months, respectively. RESULTS: Fourteen @entity1 had @entity76 @entity439 (ruptured-9, unruptured-5). There were 10 females and 4 males with the mean age of 47.2 years (median - 46 years, range = 24-66 years). @entity510 ( @entity510 ) was seen in 11 @entity1 . The mean duration of symptoms was 2.5 days (range = 1-7 days). The WFNS score at presentation was as follows: Grade 1 in 10 cases, II in 2 cases, III in 1 case and IV in 1 case. In the 9 cases with @entity1756 , average size of the @entity1756 was 7.3 mm (range = 2.5-27 mm, median = 4.9 mm). The subtemporal approach was used in the first 7 cases. The extradural temporopolar (EDTP) approach was used in the last 5 cases. Complications include @entity2553 (n = 6), @entity2895 (n = 5) and @entity1276 (n = 3). Two @entity1 died following surgery. At mean follow-up 33.8 months (median - 25 months, range = 19-96 months), no @entity1 had a rebleed. At discharge 9 (64%), had a GOS of 4 or 5 and 3 (21%) had a GOS of 3. At 6 months follow-up, 10/14 (71%) @entity1 had mRS of 0-2, and 2 (14%) had mRS of 5. CONCLUSIONS: @entity438 are uncommon and tend to rupture even when the @entity439 size is small (<7 mm). They commonly present with @entity510 . The EDTP approach avoids complication caused by temporal lobe retraction and injury to the vein of Labbe.
