title: Contralateral approach to unruptured superior hypophyseal artery aneurysms.
abstract: OBJECTIVE
  To evaluate the feasibility and limitations of the contralateral approach to unruptured superior hypophyseal artery (SHA) aneurysms.
  
  
  METHODS
  Data regarding eight cases of superior hypophyseal artery aneurysms operated on by a contralateral pterional approach at our center from January 2008 to September 2010 were collected and evaluated retrospectively. Of these eight cases, six were male and two were female. The mean age was 57.1 years (range 28 years to 77 years). All the aneurysms were unruptured; five were on right side and three were on left side. The surgical technique and outcome of patients were reviewed.
  
  
  RESULTS
  All aneurysms were successfully clipped without complication and patency of all superior hypophyseal arteries was preserved. Postoperative three-dimensional computed tomography angiography revealed residual aneurysm in only one case. None of the patients had deterioration of visual acuity or field after surgery. The contralateral pterional approach was found to be appropriate for fully exposing the aneurysmal dome and neck without retraction of the optic nerve or the carotid artery in five cases. Slight retraction of the optic nerve was required in two cases, and significant manipulation of the optic nerve was required in one case.
  
  
  CONCLUSIONS
  The contralateral pterional approach for clipping of unruptured superior hypophyseal artery aneurysms is technically feasible and safe in a select group of patients where optimal results can be achieved without significant retraction of near by neurovascular structures.
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China. csfsong143@yahoo.com.cn
authors.forename: Sifang
authors.initials: S
authors.lastname: Chen
authors.forename: Y
authors.initials: Y
authors.lastname: Kato
authors.forename: Ashish
authors.initials: A
authors.lastname: Kumar
authors.forename: Rohan
authors.initials: R
authors.lastname: Sinha
authors.forename: Daikichi
authors.initials: D
authors.lastname: Oguri
authors.forename: Jumpei
authors.initials: J
authors.lastname: Oda
authors.forename: Takeya
authors.initials: T
authors.lastname: Watabe
authors.forename: Shuei
authors.initials: S
authors.lastname: Imizu
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Sano
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hirose
mesh_terms: D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome