title: Unilateral anterior interhemispheric approach for anterior communicating artery aneurysms with horizontal head position--technical note.
abstract: The horizontal head position was adopted in the unilateral anterior interhemispheric approach to treat an anterior communicating artery (ACoA) aneurysm. The patient was placed in the supine position. The patient's head was rotated to the right to orient the midline horizontally, and tilted 45 degrees superiorly. After bicoronal skin incision and bifrontal craniotomy, the dura on the right side (downside) was opened. Dissection of the right interhemispheric fissure allowed gravity to retract the right (downside) hemisphere, which fell away from the falx, while the falx supported the upside hemisphere. The present approach was used in three patients with ACoA aneurysm between January 2009 and April 2010. The aneurysms were adequately clipped with this approach. No complication related to the approach occurred. No patients exhibited anosmia after surgery. This approach is useful for ACoA aneurysms.
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, University of Toyama, Toyama, Japan. nakamasa@iwa.att.ne.jp
authors.forename: Nakamasa
authors.initials: N
authors.lastname: Hayashi
authors.forename: Hikari
authors.initials: H
authors.lastname: Sato
authors.forename: Naoki
authors.initials: N
authors.lastname: Akioka
authors.forename: Kunikazu
authors.initials: K
authors.lastname: Kurosaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hori
authors.forename: Shunro
authors.initials: S
authors.lastname: Endo
mesh_terms: D000328:Adult; D054022:Cerebrum / Q000033:anatomy & histology / Q000098:blood supply / Q000601:surgery*; D002941:Circle of Willis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D056888:Patient Positioning / Q000379:methods* / Q000592:standards; D011859:Radiography; D014656:Vascular Surgical Procedures / Q000379:methods*