Endoscope-assisted microsurgery for cerebral aneurysms.

A total of 66 patients with intracranial aneurysms were endoscopically assisted treated during a 3 years period. Among those were five individuals with giant aneurysms and 27 patients with aneurysms of the posterior circulation. The endoscope was used only for checking the anatomical structures surround the aneurysms in 16 cases. In 43 patients the aneurysm sac was also dissected under endoscopical control. Even the clipping procedure was performed in seven cases exclusively under endoscopical observation. Only one prematural rupture occurred intraoperatively during preparation of a basilar tip aneurysm. Postoperatively three individuals with aneurysms located in the posterior circulation were temporarily neurologically impaired, and one patient with a basilar tip aneurysm suffered from a surgical related hemiparesis. The use of an endoscope in aneurysm surgery improves the visualization of the aneurysm itself and the surrounding anatomical structures. This minimizes the retraction of the nervous structures and leads to a reduced morbidity.