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Updated: Jun 24, 2026
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
[Microsurgical exposure of middle cerebral aneurysms located at the limen recess]
Ken Kazumata1, Katsuyuki Asaoka, Kouji Itamoto
1Department of Neurosurgery, Teine Keijinkai Hospital, 1-40 1-jo 12-chome, Maeda, Teine-ku, Sapporo-shi, Hokkaido 006-8555, Japan.
Objective:
To describe techniques of exposure for middle cerebral artery (MCA) aneurysms located at the limen recess.
Methods:
A retrospective review was performed of 17 patients who underwent clipping surgery, during a 3-year period, to MCA aneurysms located at the limen recess. All clinical and imaging data were reviewed.
Results:
Techniques required in the limen recess MCA aneurysms were: 1) Wide exposure of the sylvian fissure (from the distal part to the carotid cistern), 2) Secure the M1 proximal, 3) Temporary occlusion, 4) Perpendicular clip. Temporary occlusion was employed in 13 of 17 patients. No procedure related morbidity was observed.
Conclusion:
Difficulty lies in the circumstance that the aneurysm frequently has its orifice 270 degree, while the clip has to be applied perpendicular to the M2 axis in a narrow working space. Using temporary clip and extensive exposure may be the key to avoid brain damage in the surgery of MCA aneurysms located at the limen recess.
