Clipping of bilateral aneurysms of middle cerebral arteries through unilateral pterional approach

Abstract

Objective To Investigate the feasibility of clipping of bilateral aneurysms of middle cerebral arteries (MCA) through unilateral pterional approach.Methods The clinical data of 14 cases of bilateral MCA aneurysms were collected.The head CTA or DSA examination after operation and during the follow-up period (6-12 months) were reviewed.Finally the GOS scores were evaluated.Results 13 cases of patients were treated by unilateral pterional approach for the treatment of bilateral aneurysms of MCA.In 1 case,the ipsilateral aneurysm was excluded and the contralateral aneurysm was clipped.The size of all the aneurysms was less than 5mm.The contra-arteries of M1 were more than 14mm in 3 cases.The aneurysms pointed to insular lobe in 2 cases and 7 cases had the parent artery atherosclerosis.All the aneurysms were clipped.The postoperative GOS was 5 in all the patients.The postoperative head CTA or DSA examination showed that there was no aneurysm recurrence.Conclusions It was feasible for clipping of bilateral aneurysms of MCA through unilateral pterional approach.But the brain edema,contra-lateral aneurysm size,arterial aneurysm point,parent artery atherosclerosis and the length of the opposite M1 should be considered. Key words: Cerebral aneurysms; Unilateral approach; Middle cerebral artery; Bilateral; Microsurgery