title: Microsurgical management of distal anterior cerebral artery aneurysms: from basic to complex, a video review of four cases.
abstract: BACKGROUND
  Distal anterior cerebral artery (DACA) aneurysms represent 2-9 % of intracranial aneurysms. They are often more amenable to surgical rather than endovascular treatment due to the size of parent vessels.
  
  
  METHODS
  We illustrate surgical approaches for DACA aneurysms arising from different segments of the anterior cerebral artery. Cases range from simple unruptured aneurysms to complex ruptured aneurysms requiring reconstruction and intracranial bypass.
  
  
  CONCLUSIONS
  The interhemispheric approach typically provides an adequate surgical corridor for surgical clipping of DACA aneurysms. Patient positioning, image guidance, and preoperative angiography help maximize safety and efficacy of surgery.
authors.affiliation: Department of Neurosurgery, Stanford University School of Medicine, 300 Pasteur Drive, R281, Stanford, CA, 94305-5327, USA, navarro.balbuena@gmail.com.
authors.forename: Ramon
authors.initials: R
authors.lastname: Navarro
authors.forename: Kevin
authors.initials: K
authors.lastname: Chao
authors.forename: Gary K
authors.initials: GK
authors.lastname: Steinberg
mesh_terms: D017542:Aneurysm, Ruptured / Q000473:pathology / Q000601:surgery*; D020771:Anterior Cerebral Artery / Q000473:pathology / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology / Q000601:surgery*; D008488:Medical Illustration; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods