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Updated: Jun 18, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

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Microsurgical principles for anterior circulation aneurysms.

Rossana Romani¹, Aki Laakso, Mika Niemelä

¹Department of Neurosurgery, Helsinki University Central Hospital, Topeliuksenkatu 5, 00260, Helsinki, Finland.

Acta Neurochirurgica. Supplement

|December 3, 2009

Summary

This study reviews over 4,000 aneurysm surgeries, presenting a simple, fast, anatomy-preserving strategy for anterior circulation aneurysms. Early diagnosis and specialized centers improve outcomes for cerebral aneurysm treatment.

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Published on: May 11, 2011

Area of Science:

Neurosurgery
Cerebrovascular Surgery
Microsurgery

Background:

Microsurgical techniques for cerebral aneurysms have evolved.
The senior author has extensive experience treating over 4,000 patients with aneurysms.
A large catchment area in Finland provides a significant patient cohort.

Purpose of the Study:

To review experience with modified microneurosurgical techniques.
To present a strategy for treating anterior circulation aneurysms.
To emphasize the importance of early diagnosis and specialized care.

Main Methods:

Modified Yaşargil microneurosurgical techniques were employed.
The lateral supraorbital approach, a modification of the pterional approach, was utilized.
Neuroanesthesia and CSF removal techniques were used to achieve brain slack.

Main Results:

A simple, fast, normal anatomy-preserving strategy was applied.
The lateral supraorbital approach facilitated treatment with less invasive surgery.
The presented strategy has served patients well.

Conclusions:

Early diagnosis of cerebral aneurysms significantly improves treatment outcomes.
A simple, fast, anatomy-preserving surgical strategy is effective.
Cerebral aneurysm patients benefit from treatment at specialized neurovascular centers.