Neurology India
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The purpose of this study was to assess the clinical value of indocyanine green angiography (ICG) in intracranial aneurysm surgery by comparing the findings with postoperative angiographic results. ⋯ ICG angiography is a simple, reliable and cost-effective method. It provides real-time information in detecting the patency of parent, branching, perforating arteries and residual aneurysm. This technique may be a useful adjunct to improve the quality of intracranial aneurysm surgery.
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Basilar apex aneurysms (BAA) are located in interpeduncular cistern surrounded by eloquent neurovascular structures. Surgical access is difficult due to narrow surgical corridors and requires traversing through a depth of 6-8 cm of subarachnoid space. ⋯ This simple approach provides a wide surgical corridor from 5 mm below to greater than 1 cm above dorsum sellae with adequate proximal control of basilar artery. It is an option to endovascular embolization especially with large and giant, or wide-necked BAA, vertebrobasilar tortuosity, coil compaction or postcoiling re-rupture and an associated large haematoma.
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Vasoactive drug alprostadil improves microcirculation and can be effective in treating disorders of peripheral nerves. Vascular endothelial growth factor (VEGF) has been shown to have protective action in cerebral ischemia, disorders of spinal cord, and also peripheral nerves. However, the mechanism of action of VEGF in peripheral nerve injuries is uncertain. ⋯ The vasoactive agent alprostadil may reduce the pathological lesion of peripheral nerves and improve the rehabilitation of the neural function, which may relate to upregulation of the expression of VEGF, following crush injury to the peripheral nerves.