Akademik Veri Yönetim Sistemi
3rd International Rhoton Society Meeting, İstanbul, Türkiye, 22 - 26 Ağustos 2023, ss.458, (Tam Metin Bildiri)
Objectives: We present 3 cases of posterior circulation aneurysms who were operated on in the semi-sitting position. Background: Surgery in semi-sitting position has became rare for posterior circulation aneurysm surgery. This position has some advantages such as improved venous drainage, reduced intracranial pressure and blood loss. Disadvantages are air embolism, pneumocephalus and intracranial hypoperfusion. (1) Method: We retrospectively analyzed clinical records of three patients with posterior circulation aneurysms who were operated on in the sitting position. Results: Case 1: 28-year-old female patient who presented acute hydrocephalus due to a partially thrombosed, giant P3 segment PCA aneurysm. The patient was operated on in the semisitting position, and a right frontal ventricular drain was placed for brain relaxation. With posterior interhemispheric approach, the aneurysm thrombectomised and clipped. Postoperative computed tomography and magnetic resonance imaging revealed resolution of the hydrocephalus, and cerebral angiography confirmed total exclusion of the aneurysm from the circulation and occlusion of the P4 segment of the PCA, which was considered embolic. Case 2: 46-year-old female patient who presented acute hydrocephalus due to subarachnoidal hemorrhage. Cerebral angiography revealed a right sided ruptured PICA aneurysm. The patient was operated on in the semisitting position via a suboccipital craniotomy. Postoperative cerebral angiography confirmed total exclusion of the aneurysm. Case 3: 46-year-old female patient who came to hospital with complaints of severe headache, nausea and vomiting that started 10 days ago. Imagings showed subarachnoid hemorrhage and left superior cerebellar artery aneurysm. Attempted coil embolization was failed and the patient was operated on in the semi-sitting position with infratentorial-supracerebellar approach. No residual or recurrence aneurysm was detected in the control cerebral angiography. Conclusions: The semi-sitting position provides a safe surgical access for posterior circulation aneurysm surgery. Keywords: Semi-sitting Position, Posterior Circulation Aneurysm