title: Surgical experience of minipterional craniotomy with 102 ruptured and unruptured anterior circulation aneurysms.
abstract: The pterional approach was described in the 1970s and has become the most utilized cranial approach with many variations described, including the minipterional technique. Although described recently as an alternative to the pterional approach for anterior circulation aneurysms, to our knowledge a large series of cases using the minipterional approach in both ruptured and unruptured aneurysms has not been described. We present our clinical experience with the minipterional craniotomy in more than 100 ruptured and unruptured anterior circulation aneurysms. The results of 86 consecutive patients with 102 ruptured non-giant, anterior circulation aneurysms treated with early surgery utilizing the minipterional craniotomy were analyzed. Postoperative angiography was carried out in all cases. Outcome results were classified as excellent in 67 (77.9%), and good in seven (8.1%), while 16 (13.9%) patients died. The minipterional technique provides adequate surgical exposure and excellent outcomes for both ruptured and unruptured anterior circulation aneurysm clipping. It constitutes a safe and effective alternative to the pterional approach, with equivalent or potentially better aesthetic and functional outcomes.
authors.affiliation: Division of Neurological Surgery, University of Sao Paulo, Rua Maestro Cardim 808, CEP 01323-001 Sao Paulo, Brazil. Electronic address: leonardowelling@yahoo.com.br.
authors.forename: Eberval Gadelha
authors.initials: EG
authors.lastname: Figueiredo
authors.affiliation: State University of Ponta Grossa, Parana, Brazil.
authors.forename: Leonardo C
authors.initials: LC
authors.lastname: Welling
authors.affiliation: Barrow Neurological Institute, Phoenix, AZ, USA.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Preul
authors.affiliation: Division of Neurological Surgery, University of Sao Paulo, Rua Maestro Cardim 808, CEP 01323-001 Sao Paulo, Brazil.
authors.forename: Gabriel Reis
authors.initials: GR
authors.lastname: Sakaya
authors.affiliation: Division of Neurological Surgery, University of Sao Paulo, Rua Maestro Cardim 808, CEP 01323-001 Sao Paulo, Brazil.
authors.forename: Iuri
authors.initials: I
authors.lastname: Neville
authors.affiliation: Barrow Neurological Institute, Phoenix, AZ, USA.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Spetzler
authors.affiliation: Division of Neurological Surgery, University of Sao Paulo, Rua Maestro Cardim 808, CEP 01323-001 Sao Paulo, Brazil.
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000601:surgery; D003399:Craniotomy / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
keywords: Anterior circulation aneurysms; Cerebral aneurysm; Minipterional craniotomy; Pterional craniotomy; Surgical technique