Keyhole Approaches Applied to Clipping of Acutely Ruptured Intracerebral Aneurysms—A Technical Note and Case Series

Mohale, Diapo Gerald; Naicker, Denver; Ndlovu, Blessing; Leola, Keletso; Dlamini, Makhosazana; Gardner, Brian; Gani, Raazik; Mukansi, Murimisi; Ouma, John R.; Mpanza, Morena Nthuse; Profyris, Christos

doi:10.1016/j.wneu.2022.10.029

Cited by 3 publications

(4 citation statements)

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“…In total, 3552 articles were screened with 74 articles being read in full and 27 of these articles being excluded. The common reason for exclusion involved 21 articles [ 4 , 9 , 11 , 16 , 18 , 19 , 26 , 27 , 30 , 46 , 49 , 52 , 54 , 62 , 65 – 68 , 73 , 80 , 84 ] and is because the authors cited another article when describing the surgical technique. The other reasons for exclusion included as follows: one article [ 23 ] designing an approach to treat distal anterior cerebral artery aneurysms, one article [ 21 ] designed an approach that was not for cerebrovascular pathology, two articles [ 29 , 71 ] only described their technique being used in cadavers and two articles [ 24 , 28 ] only described a new subdural corridor without a novel craniotomy.…”

Section: Resultsmentioning

confidence: 99%

‘What’s in a name’, a systematic review of the pterional craniotomy for aneurysm surgery and its many modifications with a proposal for simplified nomenclature

Candy,

Van Der Veken,

Van Velthoven

2024

Acta Neurochir

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Background The pterional or frontosphenotemporal craniotomy has stood the test of time and continues to be a commonly used method of managing a variety of neurosurgical pathology. Already described in the beginning of the twentieth century and perfected by Yasargil in the 1970s, it has seen many modifications. These modifications have been a normal evolution for most neurosurgeons, tailoring the craniotomy to the patients’ specific anatomy and pathology. Nonetheless, an abundance of variations have appeared in the literature. Methods A search strategy was devised according to the 2020 Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) statement. To identify articles investigating the variations in the pterional approach, the following search terms were applied: (pterional OR minipterional OR supraorbital) AND (approach OR craniotomy OR technique). Results In total, 3552 articles were screened with 74 articles being read in full with 47 articles being included for review. Each article was examined according the name of the technique, temporalis dissection technique, craniotomy technique and approach. Conclusion This systematic review gives an overview of the different techniques and modifications to the pterional craniotomy since it was initially described. We advocate for the use of a more standardised nomenclature that focuses on the target zone to simplify the management approach to supratentorial aneurysms.

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Section: Resultsmentioning

confidence: 99%

‘What’s in a name’, a systematic review of the pterional craniotomy for aneurysm surgery and its many modifications with a proposal for simplified nomenclature

Candy,

Van Der Veken,

Van Velthoven

2024

Acta Neurochir

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“…Revaz Dzhindzhikhadze 1,2 , Renat Kambiev 2 , Andrey Polyakov 2 *, Andrey Zaitsev 2 , Anton Ermolaev 2 and Igor Bogdanovich 2 1 Russian Medical Academy of Continuous Professional Education, Moscow, Russia 2 Moscow Regional Research and Clinical Institute ("MONIKI"), Moscow, Russia *Address all correspondence to: ap.neurosurg@mail.ru A 58-year-old woman with multiple unruptured aneurysm: ICA terminus and MCA artery aneurysms.…”

Section: Author Detailsmentioning

confidence: 99%

“…It is important that minimally invasive approaches make it possible to minimize iatrogenic trauma by creating an individual surgical corridor. The principle of "individual" access to cerebral aneurysms is reduced to the use of several minimally invasive approaches depending on the specific neuroimaging pattern in comparison with the previously used algorithm and the choice of pterional craniotomy for all aneurysms of the anterior cerebral arterial circle [2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Keyhole Microsurgery for Cerebral Aneurysms

Dzhindzhikhadze,

Kambiev,

Polyakov

et al. 2023

Advances in Cerebral Aneurysm Treatment

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The choice of an effective and safe surgical approach is an important and largely outcome-determining step in the microsurgical treatment of cerebral aneurysms. Transcranial approach to aneurysm should provide proximal and distal control, visualization of the aneurysm and surrounding structures, freedom to work with microinstruments, optimal and close view of the surgical field with the necessary ergonomics and the possibility of comfortable work for the neurosurgeon. In addition, the approach should provide a low risk of associated complications, good cosmetic outcomes and patient satisfaction. Today, a neurosurgeon has a sufficient number of approaches to cerebral aneurysms. Minimally invasive approaches are the reduced model of traditional approaches and each of these approaches has a specific surgical corridor that cannot be changed during microsurgical manipulations, unless through the transition to an extended craniotomy.

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“…Entre los medicamentos más utilizados para el manejo de la hemorragia subaracnoidea por aneurisma roto, se encuentra la nimodipina, como adyuvante en cualquiera de las dos terapias (20).…”

Section: Introductionunclassified

Neurosurgical clipping vs spiral management in ruptured brain aneurysm. A systematic review

Hidalgo Acosta,

Gonzabay Jiménez,

Chávez Ruiz

et al. 2024

MedicienciasUTA

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Introducción: La rotura de aneurismas intracraneales, se pueden tratar mediante clipaje o terapia endovascular con espiral, por lo que, es necesario realizar una investigación sobre, el manejo neurocrítico y neuroquirúrgico, teniendo en consideración que la hemorragia subaracnoidea aneurismática, es una causa importante de muerte y discapacidad a nivel mundial. Objetivos: Comparar la terapia endovascular versus tratamiento quirúrgico con clipaje en pacientes con hemorragia subaracnoidea por aneurisma cerebral roto Materiales y métodos: Mediante la aplicación de criterios de inclusión y exclusión se inició la búsqueda de la revisión sistemática. Se revisaron Bases de datos como Google académico, ScienceDirect, Mendeley, Pubmed, IntechOpen, sitios web de revistas de alto prestigio, para consultar los registros e identificar estudios con el tema de búsqueda terapia endovascular versus tratamiento quirúrgico con clipaje en pacientes con hemorragia subaracnoidea por aneurisma cerebral roto. Resultados: Mayor eficacia con el tratamiento quirúrgico de los pacientes con aneurismas de la cerebral media, Rankin modificada >2 puntos: 18% para clipaje versus 24% tratamiento endovascular. Occlusion completa del aneurisma75% para el tratamiento quirúrgico versus 35% para el manejo endovascular. Oclusión completa del aneurisma. Pacientes asignados al clipaje (85%) pacientes asignados al espiral (67%). En comparación, el clipaje se asoció con una menor tasa de resangrado al alta y una mayor tasa de oclusión aneurismática a 1 año de seguimiento, la espiral redujo la tasa de vasoespasmo al alta y la tasa de resultados a 1 año fue mejor para espiral. Conclusión: La terapia endovascular, es una opción factible en pacientes con aneurismas roto de difícil abordaje quirúrgico como por ejemplo el circuito posterior cerebral, comunicante posterior, cerebelosas superiores e inferiores. El clipaje quirúrgico en el tratamiento del aneurisma cerebral roto, es la mejor opción cuando el abordaje es posible tanto por cirugía abierta, así como cirugía mínimamente invasiva, presentando altos porcentajes de oclusión completa del aneurisma. Ambas terapias representan una posibilidad en el manejo del aneurisma roto, según la localización y valorados por la escala de Rankin modificada.

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Keyhole Approaches Applied to Clipping of Acutely Ruptured Intracerebral Aneurysms—A Technical Note and Case Series

Cited by 3 publications

References 11 publications

‘What’s in a name’, a systematic review of the pterional craniotomy for aneurysm surgery and its many modifications with a proposal for simplified nomenclature

‘What’s in a name’, a systematic review of the pterional craniotomy for aneurysm surgery and its many modifications with a proposal for simplified nomenclature

Keyhole Microsurgery for Cerebral Aneurysms

Neurosurgical clipping vs spiral management in ruptured brain aneurysm. A systematic review

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