title: The Mini Supra-orbital Approach for Cerebral Aneurysm of the Anterior Portion of the Circle of Willis.
abstract: OBJECTIVE
  Various mini-invasive approaches have been developed over the last decade to expose the suprasellar area. The supraorbital approach takes a predominant place in exposing the suprasellar area and the Sylvian fissure.
  
  
  METHODS
  Based on our surgical experience, the technique of supraorbital subfrontal approach is described in detail in this article. After an eyebrow incision, a small frontal craniotomy was performed. Indications, advantages and limitations: This mini-invasive approach was indicated for patients with unruptured aneurysm, in patients with aneurysmal SAH without intracranial hypertension, and especially in elderly patients. This minicraniotomy (1) gave quick and direct access to the aneurysm; (2) provided less trauma of the temporal muscle and improved the cosmetic resuilts; and (3) reduced the risk of postoperative epidural hematoma thanks to the small detachment of the dura mater from the vault.
  
  
  CONCLUSIONS
  We concluded that this limited supraorbital approach gave adequate visualization and allows surgical manipulation within eloquent structures and can be specifically applied in absence of intracranial hypertension.
authors.affiliation: Department of Neurosurgery, Rouen University Hospital, 1, Germont Street, 76031, Rouen, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Lévêque
authors.forename: Stéphane
authors.initials: S
authors.lastname: Derrey
authors.forename: Hélène
authors.initials: H
authors.lastname: Castel
authors.forename: François
authors.initials: F
authors.lastname: Proust