What are the causes of right posterior communicating artery aneurysm and how is the surgical treatment

What causes a right posterior communicating artery aneurysm? What about surgery?

What is the cause of right posterior communicating artery aneurysm?

1 Infection: mainly syphilis, often eroding the thoracic aorta. Bacteremia of sepsis and endocarditis allows bacteria to flow into the aorta through the blood. Mycotic aneurysm can spread directly or be secondary to infection on the basis of atherosclerotic ulcer. The pathogenic bacteria are mainly streptococci, staphylococci and salmonella, which are rare.

2 Cystic medial necrosis: It is a rare lesion with unknown etiology. The elastic fibers in the middle layer of the artery are broken and replaced by metachromatic acid mucopolysaccharides. It is mainly seen in aneurysms and is more common in men. Cystic medial necrosis can occur in Marfan syndrome, Turner syndrome, El-Schmidt syndrome, etc. It is easy to cause dissecting aneurysms.

3. Atherosclerosis is the most common cause. Atherosclerosis erodes the aortic wall, destroys the middle layer components, and causes degenerative changes in elastic fibers. Due to atherosclerosis, the wall thickens, leading to vascular pressure, nutritional disorders or vascular rupture. It is more common in elderly men, with a male-to-female ratio of about 10:1. The main site is the artery, especially the renal artery originating between the iliac bifurcation.

How was the surgery?

There are many entrances for surgery. For anterior circulation aneurysms, the sphenoid wing must be pushed in first. During the operation, the sphenoid ridge is removed, and the bottom edge of the bone window is as parallel to the anterior cranial fossa as possible. CSF drainage or lateral ventricle drainage and hematoma removal are performed through subdural catheterization. The sylvian fissure cistern is dissected in sequence under a microscope, and the optic chiasm cistern and carotid cistern are released. The frontal and temporal ICA supraclinoid segments are gently pulled apart with a snake-shaped brain retractor to dissect out the PCoA, AChoA, and bifurcation. The inner edge A1 can dissect the ACoA, bilateral A1, A2 and Heubner recurrent arteries, and the posterior dissection of M1 and M2 can fully expose the Willis cisterns. Due to the dissection of the brain cistern, all anterior aneurysms are less damaged and have fewer complications.