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Supraorbital eyebrow minicraniotomy for anterior circulation aneurysms

Lookup NU author(s): Patrick Mitchell, Dr K Mahmood, Emeritus Professor David Mendelow


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Background: We report our experience with the minimally invasive supraorbital approach to aneurysms of the ipsilateral anterior cerebral circulation. Methods: A prospective review of all patients who underwent operations to clip aneurysms in Newcastle between 1993 and 2002. Results: Fifty-six aneurysms were clipped via minicraniotomy in 47 patients. Six patients presented with acute subarachnoid hemorrhage (SAH), 40 patients were admitted for elective clipping, and 1 patient presented with an SAH, had the responsible aneurysm clipped and was readmitted later for elective clipping of a further aneurysm. Bilateral supraorbital craniotomies were performed in 3 patients. In 6 patients, multiple aneurysms were clipped via a single craniotomy. All aneurysms were well visualized with the microscope. Endoscopic assistance was not found necessary. All were successfully clipped. Two aneurysms ruptured while being clipped. There was no direct mortality from surgery. One patient died later from a separate posterior circulation aneurysm. One patient had a significant long-term deficit but remained independent, and 1 had 3 seizures over the 12 months after surgery. This represents a 4% morbidity at 1 year. Conclusion: Selected anterior cerebral circulation aneurysms can be clipped with low morbidity, using an ipsilaterall minicraniotomy preserving the orbital rim, and without using an endoscope. The types of aneurysm selection criteria and operative equipment used are described. (C) 2005 Published by Elsevier Inc.

Publication metadata

Author(s): Mitchell P, Vindlacheruvu RR, Mahmood K, Ashpole RD, Grivas A, Mendelow AD, Mayberg MR

Publication type: Article

Publication status: Published

Journal: Surgical Neurology

Year: 2005

Volume: 63

Issue: 1

Pages: 47-51

ISSN (print): 0090-3019

ISSN (electronic): 1878-8769

Publisher: Elsevier Inc.


DOI: 10.1016/j.surneu.2004.02.030


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