Contralateral approach for clipping of bilateral anterior circulation aneurysms

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Patients with bilateral anterior circulation aneurysms present a management challenge. These lesions may be treated in a staged manner or alternatively, for select patients, a contralateral approach may be utilized to treat bilateral aneurysms with a single surgery. In this narrated video illustration, we present the case of a 57-year-old woman with incidentally discovered bilateral aneurysms (left middle cerebral artery [MCA], left anterior choroidal artery and right MCA). A contralateral approach through a left pterional craniotomy was performed formicrosurgical clipping of all three aneurysms. The techniques of pterional craniotomy, contralateral approach, microsurgical clipping and intraoperative angiography are reviewed.

The authors are grateful to Wuyang Yang, M.D. for his assistance.

The video can be found here: http://youtu.be/MlPIu3hQZkg.

Patients with bilateral anterior circulation aneurysms present a management challenge. These lesions may be treated in a staged manner or alternatively, for select patients, a contralateral approach may be utilized to treat bilateral aneurysms with a single surgery. In this narrated video illustration, we present the case of a 57-year-old woman with incidentally discovered bilateral aneurysms (left middle cerebral artery [MCA], left anterior choroidal artery and right MCA). A contralateral approach through a left pterional craniotomy was performed formicrosurgical clipping of all three aneurysms. The techniques of pterional craniotomy, contralateral approach, microsurgical clipping and intraoperative angiography are reviewed.

The authors are grateful to Wuyang Yang, M.D. for his assistance.

The video can be found here: http://youtu.be/MlPIu3hQZkg.

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Article Information

CORRESPONDENCE Judy Huang, M.D., Department of Neurosurgery, Bayview Medical Center, 1800 Orleans Street, Zayed Tower, Suite 6115F, Baltimore, MD 21287. email: jhuang24@jhmi.edu.

INCLUDE WHEN CITING Published online July 1, 2015; DOI: http://thejns.org/doi/abs/10.3171/2015.7.FocusVid.14599.

© AANS, except where prohibited by US copyright law.

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