1. Unilateral supraorbital keyhole approach in patients with middle cerebral artery (M1-M2 segment) symmetrical aneurysms
- Author
-
Gigante N, Distefano G, Martellotta N, Stroscio C, Maddalena Gf, Toscano S, Citro E, Settembrini G, and Tripodi M
- Subjects
medicine.medical_specialty ,Middle Cerebral Artery ,Subarachnoid hemorrhage ,Functional Laterality ,Central nervous system disease ,Aneurysm ,medicine.artery ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,In patient ,cardiovascular diseases ,Aged ,Vascular disease ,business.industry ,Intracranial Aneurysm ,General Medicine ,Subarachnoid Hemorrhage ,medicine.disease ,Surgical Instruments ,Surgery ,Cerebral Angiography ,medicine.anatomical_structure ,Middle cerebral artery ,cardiovascular system ,Female ,Neurology (clinical) ,business ,Keyhole ,Orbit ,Vascular Surgical Procedures ,Artery - Abstract
A left middle cerebral artery aneurysm at the bifurcation (M1-M2 segment) and a right smaller aneurysm, symmetrical to the previous one were diagnosed in a 69-year-old female after angiographic examination for subarachnoid hemorrhage. The preoperative radiological study did not enable us to identify the bleeding aneurysm so a left supraorbital keyhole approach was performed to operate on the bigger aneurysm. In the same surgical session, using the same way of approach, we decided to attack also the right aneurysm which then revealed itself as being responsible for bleeding. The postoperative angiograms confirmed the complete exclusion of both aneurysms and the patient was discharged after good recovery. Although there are remarkable controversies about the surgical strategies for multiple aneurysms, our experience gives us the opportunity to emphasize the supraorbital keyhole approach and to reconsider the "timing" of multiple/bilateral aneurysms.
- Published
- 2003