title: Dual ipsilateral craniotomies through a single incision for the surgical management of multiple intracranial aneurysms.
abstract: OBJECTIVE
  To examine whether multiple aneurysms located in the anterior cerebral artery (ACA), middle cerebral artery (MCA), or internal carotid artery (ICA) could be treated through single-stage, ipsilateral dual craniotomies.
  
  
  METHODS
  Investigators reviewed records of nine patients who underwent dual ipsilateral craniotomies through one incision for surgical treatment of multiple aneurysms in the anterior circulation at a single institution from 1994-2010. In all cases, a single-stage pterional and frontal interhemispheric approach through two separate, ipsilateral craniotomies under a single, extended pterional incision was used.
  
  
  RESULTS
  Dual craniotomies through one incision were performed on nine patients with multiple aneurysms without complications. This series included eight women and one man with an average age of 57 years. The mean number of aneurysms treated was 2.7 (range 2-5 aneurysms). Most patients underwent elective treatment. The pterional craniotomy approach was used to treat MCA and ICA aneurysms, whereas distal ACA aneurysms were treated through the frontal parasagittal craniotomy approach. All aneurysms were successfully treated via clip ablation. There were no perioperative or postoperative complications at an average follow-up of 29 months (range 1-131 months).
  
  
  CONCLUSIONS
  Single-stage, ipsilateral dual pterional and frontal craniotomies through one incision constitute a safe approach that can be employed for the effective surgical treatment of multiple aneurysms in joint unilateral and axial locations with excellent clinical results.
authors: Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors: Gavin P
authors: GP
authors: Dunn
authors: Brian V
authors: BV
authors: Nahed
authors: Brian P
authors: BP
authors: Walcott
authors: Henry
authors: H
authors: Jung
authors: Travis S
authors: TS
authors: Tierney
authors: Christopher S
authors: CS
authors: Ogilvy
mesh_terms: D000328:Adult; D000368:Aged; D020771:Anterior Cerebral Artery / Q000601:surgery; D003399:Craniotomy / Q000379:methods*; D004322:Drainage; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome