Bilateral supraorbital keyhole approach in surgery of multiple cerebral aneurysms: a case report and literature review

Abstract

We report a case of clipping of mirror middle cerebral artery aneurysms using a minimally invasive bilateral approach. The presented case demonstrates successful clipping of middle cerebral artery aneurysms in different vascular territories using the bilateral supraorbital approach: a skin incision along the eyebrow followed by supraorbital keyhole craniotomy. Follow-up CT angiography in the postoperative period demonstrated elimination of aneurysms from the bloodstream. The cosmetic effect after the intervention was evaluated as excellent. The bilateral supraorbital approach in surgery of multiple mirror aneurysms may be recommended as an alternative to the contralateral or bilateral pterional approach. The bilateral supraorbital approach avoids additional traction of the frontal lobes, provides a focused personalized approach, and is a safe and effective approach with excellent cosmetic results.