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The basal interhemispheric approach for acute anterior communicating aneurysms
N Yasui1, E Nathal, H Fujiwara
1Department of Surgical Neurology, Research Institute for Brain and Blood Vessels, Akita, Japan.
Acta Neurochirurgica
|January 1, 1992
Summary
The basal interhemispheric (BIH) approach offers superior surgical outcomes for ruptured anterior communicating artery (ACoA) aneurysms compared to the anterior interhemispheric (AIH) approach, with fewer complications and reduced anosmia. This study highlights BIH as a more beneficial surgical strategy.
Area of Science:
- Neurosurgery
- Vascular Neurology
Background:
- Ruptured anterior communicating artery (ACoA) aneurysms pose significant surgical challenges.
- Optimal surgical approaches are crucial for improving patient outcomes.
Purpose of the Study:
- To compare the surgical outcomes of the basal interhemispheric (BIH) approach versus the anterior interhemispheric (AIH) approach for ruptured ACoA aneurysms.
- To evaluate the efficacy and complication rates associated with each surgical technique.
Main Methods:
- Retrospective review of 85 patients with ruptured ACoA aneurysms operated within 72 hours of onset.
- Comparison of outcomes between patients treated with the BIH approach (N=48) and the AIH approach (N=37).
- Assessment of surgical outcomes using the Glasgow Outcome Scale (GOS) and complication monitoring.
Main Results:
- The BIH group showed a higher rate of excellent or good outcomes (88%) compared to the AIH group (78%).
- Patients undergoing the BIH approach experienced significantly fewer complications, including a notable absence of postoperative anosmia.
- A significant correlation between pre-operative grade and patient outcome was observed in both groups.
Conclusions:
- The basal interhemispheric (BIH) approach is associated with better surgical outcomes and a lower complication profile for ruptured ACoA aneurysms.
- The BIH approach demonstrates a clear advantage over the AIH approach in managing acute ACoA aneurysms.
- Minimizing complications like anosmia is a key benefit of the BIH surgical strategy.