[Minimally invasive surgery in intracranial aneurysms].
BACKGROUND
The use of minimally invasive procedures in neurosurgery permits a significant reduction in peri-operative morbidity and duration of hospital stay. The fronto-latero-basal (FLB) approach gives good exposure of the structures of the anterior and middle fossas with access to most aneurysms of the anterior circulation, thus avoiding extensive craniotomies and the use of brain retractors.


OBJECTIVE
We present an analysis of 27 patients operated on to clip 29 aneurysms of the anterior circulation using the FLB approach.


METHODS
The study included 27 patients, 18 women and 9 men with an average age of 47.53 years. On clinical staging, using the Hunt and Hess scale, 12 patients were between 0 and 1, 8 at stage II, 6 at stage III and 1 at stage IV.


RESULTS
The aneurysms were mainly on the internal carotid artery (16), middle cerebral artery (5), anterior communicating artery (5) and bifurcation of the carotid and middle cerebral arteries (3). The surgical operation lasted an average of 166.15 minutes; it was possible to clip the artery in 28 cases (96.5%). Two patients died (of renal failure and of disseminated intravascular coagulation). Most patients were discharged with a score of 5 points on the Glasgow prognosis scale 7.6 days after operation.


CONCLUSIONS
Use of minimally invasive procedures such as FLB gives optimal functional and aesthetic results, with the advantage of being possible using the basic instruments available in any neurosurgical department, without depending on advanced technology.
Revuelta-Gutiérrez
R
R
Servicio de Neurocirugía, Instituto Nacional de Neurología y Neurocirugía MVS, Insurgentes Sur, 3877, Colonia La Fama, Tlalpan, México D.F., México.
Arriada-Mendicoa
N
N
De Juambelz-Cisneros
P
P
Fernández-Alvarado
B
B
Flores-Orozco
J
J
Gil-Ortiz
C
C
Lara-Girón
J C
JC
D000328:Adult; D000368:Aged; D002339:Carotid Arteries / Q000601:surgery; D003399:Craniotomy / Q000379:methods*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D013525:Surgical Instruments; D016896:Treatment Outcome