title: Microsurgical principles for anterior circulation aneurysms.
abstract: Microneurosurgical techniques introduced by Prof. Yaşargil have been modified by the senior author (JH) when treating more than 4,000 patients with aneurysms at two of the Departments of Neurosurgery in Finland, Kuopio and Helsinki, with a total catchment area of close to three million people. This experience is reviewed, and the treatment of anterior circulation aneurysms by simple, fast, normal anatomy preserving strategy is presented.Most of the aneurysms of the anterior circulation are treated by using the lateral supraorbital approach, a less invasive, more frontally located modification of the pterional approach. To avoid extensive skull base surgery, a slack brain is needed and achieved by experienced neuroanesthesia and by surgical tricks for removal of CSF.Diagnosis of cerebral aneurysm before rupture improves treatment results more than any technical advances. Until this is realized, we continue to treat cerebral aneurysms by simple, fast, preserving normal anatomy-strategy, which has served our patients well.Patients with cerebral aneurysms should be treated at specialized neurovascular centers.
authors: Department of Neurosurgery, Helsinki University Central Hospital, Topeliuksenkatu 5, 00260, Helsinki, Finland.
authors: Rossana
authors: R
authors: Romani
authors: Aki
authors: A
authors: Laakso
authors: Mika
authors: M
authors: Niemelä
authors: Martin
authors: M
authors: Lehecka
authors: Reza
authors: R
authors: Dashti
authors: Puchong
authors: P
authors: Isarakul
authors: Ozgür
authors: O
authors: Celik
authors: Ondrej
authors: O
authors: Navratil
authors: Hanna
authors: H
authors: Lehto
authors: Riku
authors: R
authors: Kivisaari
authors: Juha
authors: J
authors: Hernesniemi
mesh_terms: D002536:Cerebral Arteries / Q000601:surgery*; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology / Q000601:surgery*; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods*; D019291:Skull Base / Q000601:surgery