[Treatment of intracranial anterior circulatory aneurysms via keyhole approach]

To evaluate the clinical effect of treatment of intracranial anterior circulatory aneurysm via the minimum invasive surgical technique keyhole approach.

Fifty three patients with intracranial anterior circulatory aneurysms were operated upon via keyhole approach from February to November 2000, 37 cases with ICA or MCA being operated upon via pterional approach, and 16 cases with AcoA or ACA aneurysms via frontal unilateral interhemispheric keyhole approach. A bone flap, 25 approximately 30 mm wide and 15 approximately 20 mm high, was created with a high-speed drill in craniotomy. The aneurysm was exposed through the lateral cerebral fissure or intercerebral fissure.

The intracranial anterior circulatory aneurysms in 53 cases were successfully clipped via keyhole approach, of which 5 aneurysm bodies were resected and 12 cases underwent intraoperative accidental rupture. Postoperative angiography showed that all of the aneurysms were occluded. None of the cases died after operation. The morbidity of postoperative complication was 3.8%. No approach-related complication occurred.

Keyhole approach helps to obtain the best operative effect for treatment of intracranial anterior circulatory aneurysm.