BACKGROUND: Many approaches for clipping anterior communicating artery (ACoA) aneurysms are reported in the literature. We describe here a new approach called "low anterior interhemispheric approach" for clipping of ACoA aneurysms. MATERIALS AND METHODS: A low anterior interhemispheric approach utilizing a unilateral frontal craniotomy flap with minimal unilateral frontal lobe retraction was used in treating four patients harboring an unruptured ACoA aneurysm. The approach axis is directed to the ACoA area itself with minimal exposure to the anterior cerebral vessels. FINDINGS: In all patients, complete neck clipping was possible with minimal brain retraction, without vascular damage and preserved olfaction. INTERPRETATION: This approach is preferred on anatomical grounds for cases of unruptured small and medium sized ACoA aneurysms projecting anteriorly or posteriorly because the anterior communicating artery complex area can be fully visualized with minimal manipulation of the frontal lobes and anterior cerebral arteries.
BACKGROUND: Many approaches for clipping anterior communicating artery (ACoA) aneurysms are reported in the literature. We describe here a new approach called "low anterior interhemispheric approach" for clipping of ACoA aneurysms. MATERIALS AND METHODS: A low anterior interhemispheric approach utilizing a unilateral frontal craniotomy flap with minimal unilateral frontal lobe retraction was used in treating four patients harboring an unruptured ACoA aneurysm. The approach axis is directed to the ACoA area itself with minimal exposure to the anterior cerebral vessels. FINDINGS: In all patients, complete neck clipping was possible with minimal brain retraction, without vascular damage and preserved olfaction. INTERPRETATION: This approach is preferred on anatomical grounds for cases of unruptured small and medium sized ACoA aneurysms projecting anteriorly or posteriorly because the anterior communicating artery complex area can be fully visualized with minimal manipulation of the frontal lobes and anterior cerebral arteries.
Authors: Anna Zurada; Jerzy Gielecki; R Shane Tubbs; Marios Loukas; Wojciech Maksymowicz; Michał Chlebiej; Aaron A Cohen-Gadol; Jarosław Zawiliński; Dariusz Nowak; Maciej Michalak Journal: Surg Radiol Anat Date: 2011-02-17 Impact factor: 1.246
Authors: Anthony L Petraglia; Vasisht Srinivasan; Michael J Moravan; Michelle Coriddi; Babak S Jahromi; G Edward Vates; Paul K Maurer Journal: Surg Neurol Int Date: 2011-09-17