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- W2313133604 abstract "Appropriate exposure with minimal retraction of the brain is important in operating for deeply seated aneurysms. In this paper, we describe the modified pterional approach with extensive removal of the roof and lateral wall of the orbit as well as the sphenoid wing in order to expose the superior orbital fissure. In four of the six cases, which harbored an anterior communicating artery aneurysm, the orbital rim was removed for further exposure (orbitofrontotemporal craniotomy). This approach offers the following advantages: a) multidirectional view of the aneurysm; b) wide basal exposure with minimal retraction of the brain; and c) a smaller distance from the surface to the aneurysm. For a case of high positioned basilar tip aneurysm, supraorbital frontotemporal craniotomy with detachment of the zygomatic arch was carried out. After exposure of the superior orbital fissure, the anterior clinoid process was completely extirpated and the optic canal was un-roofed via the epidural space. After the arachnoid over the Sylvian fissure was dissected widely enough so that the trifurcation of the middle cerebral artery was exposed, the dura propria and the carotid ring were incised in oder to mobilize the internal carotid artery and optic nerve. With minimal retraction of the frontal lobe and internal carotid artery medially and the temporal lobe laterally, a wide operative field was gained. This approach is very useful in accessing a high positioned basilar tip aneurysm for upward viewing from below through the wide operative space." @default.
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- W2313133604 date "1992-01-01" @default.
- W2313133604 modified "2023-10-04" @default.
- W2313133604 title "Microsurgical Approach for Cerebral Aneurysm" @default.
- W2313133604 doi "https://doi.org/10.2335/scs1987.20.1_33" @default.
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