A temporal approach to anterior communicating artery aneurysms. Technical note.

As an alternative to approaching anterior communicating artery (ACoA) aneurysms through the frontal fossa, either parasagittally or laterally (pterional, gyrus rectus approach), this report describes an approach to ACoA aneurysms through the temporal fossa. The main advantages of this temporal technique are that it requires less brain retraction, gives better surgical orientation, gains control of both A1 segments before disturbing the aneurysm, and involves minimal resection of brain tissue. This temporal approach has recently been used by the author in 20 consecutive operations for ACoA aneurysms in preference to the gyrus rectus approach.