title: Head positioning for anterior circulation aneurysms microsurgery.
abstract: OBJECTIVE
  To study the ideal patient's head positioning for the anterior circulation aneurysms microsurgery.
  
  
  METHODS
  We divided the study in two parts. Firstly, 10 fresh cadaveric heads were positioned and dissected in order to ideally expose the anterior circulation aneurysm sites. Afterwards, 110 patients were submitted to anterior circulation aneurysms microsurgery. During the surgery, the patient's head was positioned accordingly to the aneurysm location and the results from the cadaveric study. The effectiveness of the position was noted.
  
  
  RESULTS
  We could determine mainly two patterns for head positioning for the anterior circulation aneurysms.
  
  
  CONCLUSIONS
  The best surgical exposure is related to specific head positions. The proper angle of microscopic view may minimize neurovascular injury and brain retraction.
authors.affiliation: Departamento de Neurocirurgia Vascular, Universidade Federal de São Paulo, Sao Paulo, SP, Brazil.
authors.forename: Feres
authors.initials: F
authors.lastname: Chaddad-Neto
authors.affiliation: Laboratório de Microcirurgia, Instituto de Ciências Neurológicas, Real e Benemérita Associação Portuguesa de Beneficência, Sao Paulo, SP, Brazil.
authors.forename: Hugo Leonardo
authors.initials: HL
authors.lastname: Doria-Netto
authors.affiliation: Laboratório de Microcirurgia, Instituto de Ciências Neurológicas, Real e Benemérita Associação Portuguesa de Beneficência, Sao Paulo, SP, Brazil.
authors.forename: José Maria de
authors.initials: JM
authors.lastname: Campos-Filho
authors.affiliation: Departamento de Neurocirurgia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil.
authors.forename: Eduardo Santamaria Carvalhal
authors.initials: ES
authors.lastname: Ribas
authors.affiliation: Departamento de Cirurgia - LIM02, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil.
authors.forename: Guilherme Carvalhal
authors.initials: GC
authors.lastname: Ribas
authors.affiliation: Laboratório de Microcirurgia, Instituto de Ciências Neurológicas, Real e Benemérita Associação Portuguesa de Beneficência, Sao Paulo, SP, Brazil.
authors.forename: Evandro de
authors.initials: Ed
authors.lastname: Oliveira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D059925:Anatomic Landmarks; D003399:Craniotomy / Q000379:methods; D005260:Female; D006257:Head / Q000601:surgery*; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008488:Medical Illustration; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D056888:Patient Positioning / Q000379:methods*; D012016:Reference Values; D015203:Reproducibility of Results; D016896:Treatment Outcome; D055815:Young Adult