CSF leakage and anosmia in aneurysm clipping of anterior communicating artery by basal interhemispheric approach

Hirobumi Nakayama, Tastuya Ishikawa, Shingo Yamashita, Issei Fukui, Tatsushi Mutoh, Kentaro Hikichi, Shotaro Yoshioka, Hideya Kawai, Noriyuki Tamakawa, Junta Moroi, Akifumi Suzuki, Nobuyuki Yasui

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

We studied the incidence of postoperative infection related to CSF leakage and anosmia in basal interhemispheric approach (BIH). Between April, 1990 to March, 2009, 142 cases of anterior communicating (Acom) aneurysm including both unruptured and ruptured have been treated by clipping surgery using BIH. We retrospectively obtained clinical informations from medical records and video records about infectious complications, CSF leakage of cerebrospinal fluid (CSF), olfactory dysfunction and intraoperative findings of damage to the olfactory nerve. In most cases (139 patients, 97%), frontal sinus were opened at craniotomy. Of all, CSF rinorrhea occurred in 4 cases (2.8%), and meningitis in 6 cases. There was only one patient who sufferd from meningitis due to CSF rinorrhea. All that patients recovered completely without deficit. Anosmia occurred in 6 cases (4.2%). and intraoperative injuries in 4 cases (2.8%). There was only one patient in whom anosmia was consistent with nerve injury. In conclusion, BIH is an appropriate procedure for infection risk control in Acom aneurysm surgery. It is difficult to avoid olfactory dysfunction completely, even if olfactory nerves are preserved in form.

Original languageEnglish
Pages (from-to)263-268
Number of pages6
JournalNeurological Surgery
Volume39
Issue number3
Publication statusPublished - 2011 Mar 10
Externally publishedYes

Keywords

  • Anosmia
  • BIH
  • CSF leakage
  • Infection

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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