Unilateral pterional approach to bilateral cerebral aneurysms

Lynch, JoséCarlos; Andrade, Ronaldo Percopi de

doi:10.1016/0090-3019(93)90089-j

Cited by 32 publications

(12 citation statements)

References 13 publications

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“…There are only a few reports about surgical treatment of contralateral aneurysms [6,21,22] besides the contralateral approach for some types of carotid ophthalmic aneurysms [8,9,11,24,28]. We believe that the ideal treatment for multiple aneurysms should be radical single-stage surgery for all aneurysms including, if possible, the ones arising on the contralateral side.…”

Section: Discussionmentioning

confidence: 98%

Anatomical and technical aspects of the contralateral approach for multiple aneurysms

et al. 1996

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Microsurgery of multiple aneurysms is still a controversial subject. In order to avoid the risk of rebleeding and the consequent increase in morbidity in such cases all aneurysms or at least as many aneurysms as possible should be treated in the first operative procedure. To reach that goal aneurysms located on the contralateral side should also be considered for clipping during the first operation. Between 1984 and 1994 a series of 51 patients harboring multiple aneurysms of which 55 aneurysms were located on the contralateral side of the craniotomy were operated at our institution. No mortality or morbidity could be directly ascribed to the aneurysm that was clipped contralaterally. Based on that series we have described the anatomical features, technical aspects and surgical difficulties of approaching bilateral aneurysms through the same craniotomy.

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Section: Discussionmentioning

confidence: 98%

Anatomical and technical aspects of the contralateral approach for multiple aneurysms

et al. 1996

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“…The successful management of supratentorial aneurysms by keyhole supraorbital craniotomy has recently been reported 9,10,13,17,21,24,[26][27][28][29][30][31][32] . However, a remarkable controversy remains regarding the choice between the supraorbital keyhole approach 9,32) , and the pterional approach 12,16) , which is the traditional method for the surgical management of patients with anterior circulation aneurysms. Here, we describe our preliminary experience with the supraor-bital keyhole approach for the clipping of anterior circulation aneurysms and compare it with the traditional pterional approach in terms of patient's subjective outcome assessment.…”

Section: Introductionmentioning

confidence: 99%

Microsurgical Experience with Supraorbital Keyhole Operations on Anterior Circulation Aneurysms

Park

Han

2009

J Korean Neurosurg Soc

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Objective : Conventional pterional approach is a commonly used neurosurgical technique for the treatment of cerebral aneurysms. However, this technique requires more extensive brain exposure than other key hole approaches and is sometimes associated with surgical traumatization or cosmetic problems. The aim of this study was to compare the postoperative outcome between pterional and supraorbital keyhole approaches in the patients with anterior circulation aneurysms. Methods :The authors reviewed patients with anterior circulation aneurysms who underwent aneurysm clipping via pterional or supraorbital keyhole approach at a single institute over a period of 2 years. Ninety-eight patients harboring 108 aneurysms were included in this study. Various outcomes were recorded, which included clinical grade, cosmetic problems, patients' satisfaction and complications such as chewing discomfort, frontal muscle weakness, hyposmia, infection. Results :The supraorbital approach exhibited a shorter operation time compared with the pterional approach. Complications such as chewing discomfort occurred less frequently in the supraorbital approach group. Moreover, the cosmetic outcome was significantly better in the supraorbital group than in the pterional group. Conclusion : The supraorbital keyhole approach reduced intra-and postoperative complications, including chewing discomfort and cosmetic disturbances, compared with the conventional pterional approach.

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“…1,2 The bilateral MIA are usually symmetrically placed in the internal carotid system. 3 Of the various options available, treatment of patients harboring MIA, when feasible, through a unilateral craniotomy, has the obvious advantage of avoiding a second craniotomy and remains an important consideration when planning treatment.…”

Section: Introductionmentioning

confidence: 99%