Shared Flashcard Set

Details

Craniotomy for Aneurysm Repair
Surgical Procedure
18
Medical
Professional
04/22/2019

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Cards

Term
What is an aneurysm?
Definition
A weakened spot in the walls of an artery that will cause them severely thin over time
Term
What is alarming about cerebral aneurysms?
Definition
They are usually asymptomatic until they rupture, unless they are large enough to press on surrounding structures such as optic chiasma or optic nerves
Term
What signs are present when the aneurysm ruptures?
Definition
bloody spinal fluid, meningeal irritation, and focal signs of cerebral damage
Term
Where are cerebral aneurysms typically found?
Definition
At the bifurcation points in the arteries of the Circle of Willis
Term
What is used to diagnose and located the aneurysm?
Definition
An angiography will help locate the aneurysm as well as reveal exact size of it
Term
What type of set should be available for hemorrhage control?
Definition
A carotid artery set
Term
What fissure is split by bipolar cautery?
Definition
The Sylvian fissure
Term
What types of self-retaining retractors can be used?
Definition
Leyla-Yasargil or Greenberg
Term
What structures need to be identified?
Definition
The optic nerves and optic chiasma
Term
Why is a temporary aneurysm clip used?
Definition
It is to test an eventual placement of a permanent clip, or it can be used to occlude the parent vessel if a rupture occurs and the neck of the aneurysm cannot be visualized for clip placement
Term
What can be used to prevent vasospasms?
Definition
Papaverine
Term
Why is it important the aneurysm clip is placed appropriately?
Definition
If the clip is closed then opened, it cannot be closed and reused again
Term
What can be done with a C-arm?
Definition
An angiogram can be performed during the procedure
Term
What is monitored while patient is in ICU?
Definition
Postoperative bleeding and intracranial pressure
Term
How long is the patient monitored while in the ICU?
Definition
24 to 48 hours
Term
Where do more than 85 percent of aneurysms occur?
Definition
Carotid circulation
Term
What is the goal of the surgical procedure?
Definition
To isolate the aneurysm from the parent vessel and place a clip across the neck of the aneurysm - or place a reinforcement over sac if a clip cannot be used
Term
If a clip cannot be used, what types of materials can be used to reinforce sac of aneurysm?
Definition
Polymethyl methacrylate or a mesh gauze
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