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Background: Paraclinoid aneurysms represent a challenge for neurosurgeons due to the anatomical complexity of this region. Then, innovative techniques such as the extradural sphenoid ridge approach are suitable for a safe microsurgical clipping.
Method: A description of the surgical technique was made by the senior author, a vascular neurosurgeon experienced with the use of this approach in the management of paraclinoid aneurysms exemplified through a clinical case.
Conclusion: Microsurgical clipping through an extradural sphenoid ridge keyhole approach for small and midsize paraclinoid aneurysms is an excellent treatment modality with good clinical and surgical results.
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http://dx.doi.org/10.1007/s00701-023-05760-x | DOI Listing |
Cureus
July 2025
Otolaryngology - Head and Neck Surgery, King Fahad Armed Forces Hospital, Jeddah, SAU.
Fungal pseudoaneurysms of the internal carotid artery (ICA) are rare, life-threatening complications of invasive fungal sinusitis, particularly in immunocompromised patients. These pseudoaneurysms typically occur in the cavernous segment due to its proximity to the sphenoid sinus and often present with massive epistaxis or neurological deficits. The supraclinoid ICA segment is a rare location for these aneurysms and carries risks of both intracranial and sinonasal hemorrhage.
View Article and Find Full Text PDFJ Neurosurg
August 2025
Departments of1Neurological Surgery.
Objective: The endoscopic endonasal approach (EEA) provides a ventral surgical corridor, which can be advantageous in the management of carefully selected cerebral aneurysms. The literature lacks large series to better delineate the indications and limitations of this technique. The aim of this study was to elucidate the technique's safety, indications, advantages, and limitations, as well as its evolution over time.
View Article and Find Full Text PDFNeurol India
July 2025
Department of Neurosurgery, LTMG Hospital, Sion, Mumbai, Maharashtra, India.
Superior hypophyseal artery aneurysms are rare. Symptomatic superior hypophyseal artery aneurysm commonly presents with subarachnoid hemorrhage, uncommonly with cranial nerve deficits, and very rarely with visual impairment. Microsurgical management of such aneurysms is quite complex considering the anatomical structures in the paraclinoid region.
View Article and Find Full Text PDFActa Neurochir (Wien)
July 2025
Division of Pediatric Neurosurgery, Department of Neurosurgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Paraclinoid aneurysms continue to present a surgical challenge, even in the modern endovascular era. Although these aneurysms are uncommon, surgical clipping remains the treatment of choice in select cases. Successful surgical management requires both extensive experience and a comprehensive understanding of paraclinoid anatomy.
View Article and Find Full Text PDFPurpose: Flow-diverter stents (FDSs) are being increasingly used for endovascular treatment of paraclinoid aneurysms. However, their impact on ophthalmic artery (OA) flow and retinal microvasculature remains unclear. Using optical coherence tomography angiography (OCTA), we evaluated the microvascular changes after FDS placement on the OA.
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