Left pterional craniotomy for thrombectomy and clipping of ruptured left XXXX .

@entity1 @entity410 @entity510 @entity117 @entity3194 @entity439 @entity10 @entity438
UNASSIGNED: @entity439 present a challenge to cerebrovascular surgeons on many fronts. These lesions have significant mass effect on surrounding tissues and are often partially thrombosed with thickened or calcified walls; these difficulties are amplified in cases of @entity510 . The treatment of these lesions often requires debulking or resection of the @entity439 with or without trapping and bypassing the @entity439 segment. The case presented is of a @entity1 with a @entity438 presenting with @entity410 . The treatment of this giant @entity439 involves dissection, opening and internal evacuation including the use of ultrasonic aspiration, resection, and clipping. The @entity1 was given @entity117 preoperatively in preparation for possible superficial temporal artery-MCA or saphenous vein bypass if clipping was not possible. Vessel patency was evaluated using intraoperative Doppler and @entity3194 angiography. Intraoperative somatosensory and motor evoked potential monitoring is performed in all cases. Postoperatively, the @entity1 was neurologically intact. At 1 year his modified Rankin Scale is 1, with his only symptom being intermittent @entity10 . The video can be found here: http://youtu.be/8dimNdiIObE .
