[Evaluation of the surgical results of the interhemispheric approach in comparison with the pterional approach for anterior communicating artery aneurysms].
From 1986 to 1990, 77 cases of ruptured anterior communicating artery (Aco) aneurysms have been operated on through an interhemispheric approach or a pterional approach. In this study, we mainly investigated the following factors: surgical outcome, surgical complications, degree of evacuation of subarachnoid clot, and frequency of symptomatic vasospasm. The difference of outcome between the two surgical groups was not statistically significant. Each operating method had characteristic surgical complications. Pterional approach had a tendency to complicate premature rupture, sacrifice small vessels around the aneurysm, and to result in Korsakoff syndrome and inadequate clipping. Interhemispheric approach was apt to complicate cerebral contusion, bilateral olfactory nerve injury and hemorrhagic infarction due to sacrifice of the bridging veins. The pterional approach could evacuate more of the subarachnoid clot than could the interhemispheric approach, but there was no significant difference in frequency of symptomatic vasospasm depending on which method was used.
Tamatani
S
S
Department of Neurosurgery, Nagaoka Red Cross Hospital, Japan.
Toyama
M
M
Kawaguchi
T
T
Yamamoto
K
K
Hara
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003399:Craniotomy / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome