Abstract
Among the various causes of intraoperative neurosurgical complications, a major arterial injury is one of the most devastating. Herein, the authors present a case of a 76-year-old patient who underwent removal of a craniopharyngioma via the pterional approach and experienced severe damage of her sclerotic left internal carotid artery because it was retracted excessively by a brain spatula, which resulted in complete sacrifice of the vessel. Despite stable parameters on intraoperative monitoring of motor evoked potentials and sufficient collateral blood flow, confirmed by Doppler flowmetry, a large infarct in the left cerebral hemisphere was noted after surgery. Although retraction of movable arteries, veins, and cranial nerves can often be done safely during neurosurgical procedures for effective exposure of the operative field, forced displacement of a sclerotic internal carotid artery in its paraclinoid portion anchored to the fixed distal dural ring should definitely be avoided because it poses a significant risk of major vessel damage.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Hongo K, Tanaka Y, Horiuchi T, Tada T, Kobayashi S. Internal carotid artery rotation technique to expose an aneurysm neck: technical note. Neurosurgery. 2003;52:455–7.
Kobayashi S, Kyoshima K, Gibo H, Hegde SA, Takemae T, Sugita K. Carotid cave aneurysms of the internal carotid artery. J Neurosurg. 1989;70:216–21.
Sugita K, Kobayashi S. Aneurysm. In: Sugita K, editor. Microneurosurgical atlas. Berlin: Springer; 1985. p. 10–135.
Sugita K, Kobayashi S, Takemae T, Matsuo K, Yokoo A. Direct retraction method in aneurysm surgery: technical note. J Neurosurg. 1980;53:417–9.
Sugita K, Kobayashi S, Takemae T, Tada T, Tanaka Y. Aneurysms of the basilar artery trunk. J Neurosurg. 1987;66:500–5.
Conflict of Interest Statement
The authors have no conflict of interest concerning the reported materials or methods.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 Springer Nature Switzerland AG
About this paper
Cite this paper
Hongo, K., Sakai, K., Goto, T., Horiuchi, T. (2023). Injury of the Internal Carotid Artery During Dissection of a Craniopharyngioma via the Pterional Approach: Case Report. In: Turel, K.E., Chernov, M.F., Sarkar, H. (eds) Complications in Neurosurgery. Acta Neurochirurgica Supplement, vol 130. Springer, Cham. https://doi.org/10.1007/978-3-030-12887-6_5
Download citation
DOI: https://doi.org/10.1007/978-3-030-12887-6_5
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-12886-9
Online ISBN: 978-3-030-12887-6
eBook Packages: MedicineMedicine (R0)