Clinical Neuroanatomy

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Lecture about clinical Neuroanatomy by Prof. DR. dr. Eka Sp.BS

Text of Clinical Neuroanatomy

KULIAH UPH

CLINICAL NEUROANATOMY Prof. DR. DR. EKA J. WAHJOEPRAMONO,M.D.,PhD.Yesaya , Julius, Harsan, Lutfi, Binsar, Made, Ferry, Firdaus, Evelyn, Ronny, Maximilan, Eko, Onnie, Wily, GdeFaculty of Medicine - Pelita Harapan UniversityNeuroscience Center Neurosurgery Department - Siloam Hospitals

President International Conference Cerebro Vascular SurgeryDean of FK-UPH-Chairman Neuroscience Siloam HospitalsEducational Committee World Federation Neurosurgical Societies

1

247

Circle of willis Anatomy

4Angiografi susi

646

747

848

STROKESTROKEIschemicHemorhagicBypassHemi-CraniectomyHipertensive (80 %)Non-hipertensiveKonservativeOperative Mass effect Superficial Hidrocephalus Aneurysm AVM Cavernoma

10Angiografi susi

Ischemic Stroke

12Angiografi susi

Bypass SurgeryAnastomosisSTA - MCA

13

Bif Carotid Artery Stenosis

14welly

Middle Cerebral Artery Stenosis

Case Report

STROKESTROKEIschemicHemorhagicBypassHemi-CraniectomyHipertensive (80 %)Non-hipertensiveKonservativeOperative Mass effect Superficial Hidrocephalus Aneurysm AVM Cavernoma

Hemorrhagic StrokeHypertensive Stroke

19Angiografi susi

20Angiografi susi

Case Report0 day11 days15 days

LOCATION:IC P Com: 240Anterior Communicating Artery: 103Middle Cerebral Artery: 70Basilar Artery: 58Vertebral Artery: 45Pericallosal Artery: 34IC Ophthalmic Artery: 20Other: 30

TOTAL : 600

600 Cases of Aneurysm Surgeryin Siloam HospitalFemale : 365Male : 235

Ruptured : 499Unruptured : 101

TOTAL : 600Since January 1996

22

Pathophysiology

24Angiografi susi

25Angiografi susi

Surgical Aspect

Angiography

Posterior Communicating Artery Aneurysm

3D - CT

Anterior Communicating Artery Aneurysm

Surgery of Anterior Communicating Artery Aneurysm

Surgery Of PCom AneurysmCase Report :

Midle Cerebral Artery Aneurysm

Vertebro-Basiler Aneurysm

Middle Cerebral Artery Aneurysm surgery CASE REPORT

36CTA

Giant Aneurysm surgery CASE REPORT

37CTA

Arteriovenous malformation

3D CT for AVM

Surgery of Thrombosed Varyx AVMs

Carotid-Cavernous Fistula

42Tambahin gambar netter

Case ReportPre-EmbolizationPost-Embolization

Pre-Embolization

Post-Embolization

Cavernous Angioma

45Mri cavernous angioma, preop

Definition:

Vascular anomaly characterized by the presence of sinusoidal-like capillary vessels.

Epidemiology:

Comprise 5-13% of CNS vascular malformationLocation: Mainly Supra tentorial, 10-23% are in posterior fossa, mostly in the pons.

Supra Tentorial Lesion

Infra Tentorial Lesion

48Mri cavernous angioma, preop

Brainstem Cavernous Angioma

Pre-Op

49Verterbralis aneurysm

Surgery of Brainstem Cavernous AngiomaSuboccipital-Midline Posterior Approach

Post-Op

51Mri postop

Thank You