Dual Ipsilateral Craniotomies Through a Single Incision for the Surgical Management of Multiple Intracranial Aneurysms

Objective To examine whether multiple aneurysms located in the anterior cerebral artery (ACA), middle cerebral artery (MCA), or internal carotid artery (ICA) could be treated through single-stage, ipsilateral dual craniotomies. Methods Investigators reviewed records of nine patients who underwent du...

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Bibliographic Details
Published in:World neurosurgery 2012-03, Vol.77 (3), p.502-506
Main Authors: Dunn, Gavin P, Nahed, Brian V, Walcott, Brian P, Jung, Henry, Tierney, Travis S, Ogilvy, Christopher S
Format: Article
Language:English
Subjects:
Adult
Aged
Anterior Cerebral Artery - surgery
Craniotomy - methods
Drainage
Dual craniotomies
Female
Humans
Intracranial Aneurysm - surgery
Male
Middle Aged
Middle Cerebral Artery - surgery
Multiple intracranial aneurysms
Neurosurgery
Neurosurgical Procedures - methods
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome
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Summary:Objective To examine whether multiple aneurysms located in the anterior cerebral artery (ACA), middle cerebral artery (MCA), or internal carotid artery (ICA) could be treated through single-stage, ipsilateral dual craniotomies. Methods Investigators reviewed records of nine patients who underwent dual ipsilateral craniotomies through one incision for surgical treatment of multiple aneurysms in the anterior circulation at a single institution from 1994–2010. In all cases, a single-stage pterional and frontal interhemispheric approach through two separate, ipsilateral craniotomies under a single, extended pterional incision was used. Results Dual craniotomies through one incision were performed on nine patients with multiple aneurysms without complications. This series included eight women and one man with an average age of 57 years. The mean number of aneurysms treated was 2.7 (range 2–5 aneurysms). Most patients underwent elective treatment. The pterional craniotomy approach was used to treat MCA and ICA aneurysms, whereas distal ACA aneurysms were treated through the frontal parasagittal craniotomy approach. All aneurysms were successfully treated via clip ablation. There were no perioperative or postoperative complications at an average follow-up of 29 months (range 1–131 months). Conclusions Single-stage, ipsilateral dual pterional and frontal craniotomies through one incision constitute a safe approach that can be employed for the effective surgical treatment of multiple aneurysms in joint unilateral and axial locations with excellent clinical results.
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2011.07.005