Surgical experience of minipterional craniotomy with 102 ruptured and unruptured anterior circulation aneurysms |
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| Affiliation: | 1. Division of Neurological Surgery, University of Sao Paulo, Rua Maestro Cardim 808, CEP 01323-001 Sao Paulo, Brazil;2. State University of Ponta Grossa, Parana, Brazil;3. Barrow Neurological Institute, Phoenix, AZ, USA;1. Stroke Unit and Department of Neurology, Monash Medical Centre, Melbourne, Australia;2. Anatomical Pathology Department, The Alfred Hospital, Melbourne, Australia;3. Stroke and Ageing Research Group, Southern Clinical School, Department of Medicine, Monash University, Melbourne, Australia;1. Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan 701, Taiwan;2. Department of Mechanical Engineering, National Cheng Kung University, Tainan, Taiwan;1. Department of Cardiothoracic Surgery, Barwon Health, Geelong, Vic, Australia;2. Geelong Vascular Unit, Barwon Health, Geelong, Vic, Australia;3. Department of Epidemiology and Preventive Medicine, Monash University, Vic, Australia;1. Department of Clinical Neuroscience, Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan;2. Department of Radiology, Institute of Health Biosciences, Tokushima University Graduate School, Tokushima, Japan;1. Department of Orthopedics, The First Affiliated Hospital of China Medical University, No. 155 Nanjingbei Street, Heping District, Shenyang 110001, Liaoning, China;2. Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China |
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| Abstract: | The pterional approach was described in the 1970s and has become the most utilized cranial approach with many variations described, including the minipterional technique. Although described recently as an alternative to the pterional approach for anterior circulation aneurysms, to our knowledge a large series of cases using the minipterional approach in both ruptured and unruptured aneurysms has not been described. We present our clinical experience with the minipterional craniotomy in more than 100 ruptured and unruptured anterior circulation aneurysms. The results of 86 consecutive patients with 102 ruptured non-giant, anterior circulation aneurysms treated with early surgery utilizing the minipterional craniotomy were analyzed. Postoperative angiography was carried out in all cases. Outcome results were classified as excellent in 67 (77.9%), and good in seven (8.1%), while 16 (13.9%) patients died. The minipterional technique provides adequate surgical exposure and excellent outcomes for both ruptured and unruptured anterior circulation aneurysm clipping. It constitutes a safe and effective alternative to the pterional approach, with equivalent or potentially better aesthetic and functional outcomes. |
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| Keywords: | Anterior circulation aneurysms Cerebral aneurysm Minipterional craniotomy Pterional craniotomy Surgical technique |
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