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Middle cerebral artery embolectomy. Case report.

A patient who developed an embolic occlusion of the right middle cerebral artery while undergoing a cerebral arteriogram was successfully operated on by removal of the embolus under the surgical microscope. Early postoperative cerebrovascular spasm was a factor in the transient deterioration of the patient's neurological condition. When the patient was last seen 2 1/2 months after surgery she was almost intact neurologically with only a mild right parietal dysfunction but with total resolution of the left hemiplegia. The literature is reviewed.

Adult↗

Direct embolectomy of the basilar artery bifurcation. Case report.

The case is presented of a 27-year-old man who developed a basilar artery bifurcation embolus encompassing Hilal microcoil as a complication following therapeutic embolization. An immediate direct surgical approach to the basilar artery bifurcation enabled the microcoil and associated thrombus to be removed and flow to be restored in the basilar artery and its distal branches. Postoperatively, the patient made a good recovery and on discharge was neurologically normal with the exception of a right third nerve palsy. This case suggests that in selected patients a direct surgical approach to the top of the basilar artery may be possible for treatment of emboli.

Adult↗

Embolization to the superior mesenteric artery. Arteriography and embolectomy in four cases.

Four patients were operated upon for embolization to the superior mesenteric artery. Preoperative arteriography was performed in all cases. Two patients who had had symptoms prior to operation for six and eight days respectively died postoperatively. One patient died 2 1/2 months after the operation from her underlying heart disease, while one patient was discharged with intact bowel function. The value of preoperative arteriography and the principles for surgical treatment are discussed.

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