Low Anterior Interhemispheric Approach - A Narrow Corridor to Aneurysms of the Anterior Communicating Artery

Abstract

This approach is preferred on anatomical grounds for cases of unruptured small and medium sized ACoA aneurysms projecting anteriorly or posteriorly because the anterior communicating artery complex area can be fully visualized with minimal manipulation of the frontal lobes and anterior cerebral arteries.

Three‐dimensional morphometry of the A2 segment of the anterior cerebral artery with neurosurgical relevance

“…The ACoA complex is important from clinical point of view (El-Noamany et al 2001). Various tortuosity metric evaluations of vascular segments might be used during the evaluation of normal physiological vessels curvatures and may help to differentiate various malignancies (Bullitt et al, 2003(Bullitt et al, , 2005Parikh et al, 2004).…”

An Effective Method of Frontal Sinus Reconstruction After Bifrontal Craniotomy: Experience with 103 Patients

“…B ifrontal craniotomy is effective for the treatment of anterior skull base tumors (5,6,16,18) and anterior cerebral artery aneurysms (1,4,13,18,21,32). However, the frontal sinus (FS) is often opened during this surgery, and various postoperative complications may occur as a result of the open FS, including cerebrospinal fluid (CSF) leakage and infection (e.g., meningitis, brain abscess, subdural abscess, epidural abscess, and subcutaneous or subperiosteal abscess) (5,8,10,17,18,20,22,25,26,32).…”

Clipping of the Anterior Communicating Artery Aneurysm without Sylvian Fissure Dissection

“…When the aneurysm is positioned high from the anterior clinoid process and it is projected in a superior direction, interhemispheric approach is preferred 5) . If large AComA is directed superiorly, orbitozygomatic approach or subfrontal approach are preferred 1,3) . But, the choice of approach to AComA has depended largely on the surgeon's preference and experience 1) .…”

“…The lateral approaches include pterional approach, orbitozygomatic approach, and orbitopterional approach. The anterior approaches consist of anterior interhemispheric approach and subfrontal approach 3) . Aneurysm location, direction, and size must be considered to select each operative approaches 3) .…”

“…The anterior approaches consist of anterior interhemispheric approach and subfrontal approach 3) . Aneurysm location, direction, and size must be considered to select each operative approaches 3) . Yasargil 10) reported excellent surgical results by the pterional approach, and therefore, along with its technial easiness, his approach gained unanimous support and has been widely accepted as a standard procedure.…”