Feres Chaddad-Neto1, Hugo Leonardo Doria-Netto2, José Maria de Campos-Filho2, Eduardo Santamaria Carvalhal Ribas3, Guilherme Carvalhal Ribas4, Evandro de Oliveira2. 1. Departamento de Neurocirurgia Vascular, Universidade Federal de São Paulo, Sao Paulo, SP, Brazil. 2. Laboratório de Microcirurgia, Instituto de Ciências Neurológicas, Real e Benemérita Associação Portuguesa de Beneficência, Sao Paulo, SP, Brazil. 3. Departamento de Neurocirurgia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil. 4. Departamento de Cirurgia - LIM02, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil.
Abstract
OBJECTIVE: To study the ideal patient's head positioning for the anterior circulation aneurysms microsurgery. METHOD: We divided the study in two parts. Firstly, 10 fresh cadaveric heads were positioned and dissected in order to ideally expose the anterior circulation aneurysm sites. Afterwards, 110 patients were submitted to anterior circulation aneurysms microsurgery. During the surgery, the patient's head was positioned accordingly to the aneurysm location and the results from the cadaveric study. The effectiveness of the position was noted. RESULTS: We could determine mainly two patterns for head positioning for the anterior circulation aneurysms. CONCLUSION: The best surgical exposure is related to specific head positions. The proper angle of microscopic view may minimize neurovascular injury and brain retraction.
OBJECTIVE: To study the ideal patient's head positioning for the anterior circulation aneurysms microsurgery. METHOD: We divided the study in two parts. Firstly, 10 fresh cadaveric heads were positioned and dissected in order to ideally expose the anterior circulation aneurysm sites. Afterwards, 110 patients were submitted to anterior circulation aneurysms microsurgery. During the surgery, the patient's head was positioned accordingly to the aneurysm location and the results from the cadaveric study. The effectiveness of the position was noted. RESULTS: We could determine mainly two patterns for head positioning for the anterior circulation aneurysms. CONCLUSION: The best surgical exposure is related to specific head positions. The proper angle of microscopic view may minimize neurovascular injury and brain retraction.