title: Technical nuances of clipping a middle cerebral artery bifurcation aneurysm.
abstract: Broad-necked middle cerebral artery aneurysms present unique challenges for the vascular neurosurgeon, who must contend with smaller vessels and often a complex clipping strategy. Due to their superficial location, these lesions are still commonly selected for microsurgical clipping. We present a case of a 42-year-old woman with significant vascular disease with a right middle cerebral artery aneurysm. We discuss the key surgical steps, demonstrate the microsurgical dissection and intraoperative rupture encountered and the final clipping strategy, as well as the postoperative course in this operative video presentation. The video can be found here: http://youtu.be/qZ2gvqz7XdQ .
authors.affiliation: Department of Neurosurgery, Louisiana State University, Shreveport, Louisiana.
authors.forename: Piyush
authors.initials: P
authors.lastname: Kalakoti
authors.affiliation: Department of Neurosurgery, Louisiana State University, Shreveport, Louisiana.
authors.forename: Shyamal C
authors.initials: SC
authors.lastname: Bir
authors.affiliation: Department of Neurosurgery, Louisiana State University, Shreveport, Louisiana.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Murray
authors.affiliation: Department of Neurosurgery, Louisiana State University, Shreveport, Louisiana.
authors.forename: Osama
authors.initials: O
authors.lastname: Ahmed
authors.affiliation: Department of Neurosurgery, Louisiana State University, Shreveport, Louisiana.
authors.forename: Anil
authors.initials: A
authors.lastname: Nanda
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D008866:Microsurgery / Q000379:methods*; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D013525:Surgical Instruments; D015898:Tomography Scanners, X-Ray Computed
keywords: MCA bifurcation; aneurysm; clipping; video