Horizontal contralateral approach for the distal anterior cerebral artery aneurysm: technical note

Background: The authors present a modified interhemispheric approach for the distal ACA aneurysm to resolve several problems including the narrow surgical corridor, the difficulty of proximal control, and the aneurysmal projection toward the surgeon. Methods: We refined the positions of the patient's head and the surgeon. The patient's head is fixed with flexion and tilted to the contralateral side. The surgeon sits on the contralateral side of the patient and not on the cranial side. Results: The present approach allows the surgeon to comfortably use both hands in the horizontal operative filed, to obtain a minimum retraction of the brain, and to easily secure the proximal artery. Conclusions: This modified interhemispheric approach is useful for a patient with the distal ACA aneurysm.ArticleSURGICAL NEUROLOGY. 72(1):65-68 (2009)journal articl

Vertebral Artery Dissecting Aneurysm Treated by Proximal Occlusion and Posterior Inferior Cerebellar Artery Reconstruction With Fenestrated Clips

A 57-year-old man presented with subarachnoid hemorrhage caused by a dissecting aneurysm of the vertebral artery close to the origin of the posterior inferior cerebellar artery (PICA). The aneurysm was treated successfully with two fenestrated clips preserving the efferent artery with anterograde blood flow without PICA anastomosis. The postoperative course was uneventful. Postoperative angiography indicated disappearance of the aneurysm and anterograde blood flow of the PICA.ArticleNEUROLOGIA MEDICO-CHIRURGICA. 50(8):655-658 (2010)journal articl