title: The basal interhemispheric approach for acute anterior communicating aneurysms.
abstract: We reviewed the surgical outcome in 85 patients with ruptured anterior communicating artery (ACoA) aneurysms, who were operated on within 72 hours of onset via a basal interhemispheric (BIH) approach (Group 1, N = 48), or an anterior interhemispheric (AIH) approach (Group 2, N = 37). The age, sex ratio and pre-operative grade (Gr) were similar for both groups. The outcome at the time of discharge was as follows for group 1: excellent or good 88%; fair, 6%; vegetative state, 2% and death 4%. For group 2, it was: excellent or good 78%; fair, 16%; vegetative state, 3%; and death, 3%. A significant correlation between admission grade and outcome was found in both groups. The outcome in group 1 was better than in group 2 for patients with a Glasgow Outcome Scale (GOS) better than fair (p < 0.07). No patient in group 1 had postoperative anosmia, but nine patients in group 2 became anosmic. The total number of complications was also significantly less in group 1. Our overall mortality rate was 4%. In conclusion, the BIH approach was more beneficial for treating acute ACoA aneurysm.
authors.affiliation: Department of Surgical Neurology, Research Institute for Brain and Blood Vessels, Akita, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Yasui
authors.forename: E
authors.initials: E
authors.lastname: Nathal
authors.forename: H
authors.initials: H
authors.lastname: Fujiwara
authors.forename: A
authors.initials: A
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000601:surgery; D004292:Dominance, Cerebral / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D002532:Intracranial Aneurysm / Q000601:surgery*; D007431:Intraoperative Complications / Q000601:surgery; D002546:Ischemic Attack, Transient / Q000175:diagnosis; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000175:diagnosis; D013345:Subarachnoid Hemorrhage / Q000601:surgery