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Updated: May 23, 2026
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Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
The "agnes fast" craniotomy: the modified pterional (osteoplastic) craniotomy.
Haim Ezer1, Anirban Deep Banerjee, Cedric Shorter
1Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana.
Summary
The Agnes Fast craniotomy offers a rapid pterional approach, preserving the temporalis muscle and its attachments. This technique simplifies the procedure, making it ideal for emergent neurosurgical interventions.
Area of Science:
- Neurosurgery
- Surgical Techniques
Background:
- Pterional craniotomy is a common neurosurgical approach.
- Preserving the temporalis muscle is often desired but can complicate the procedure.
Purpose of the Study:
- To introduce and evaluate the Agnes Fast craniotomy, a modified pterional approach.
- To assess the feasibility, speed, and muscle preservation of this technique.
Main Methods:
- The Agnes Fast craniotomy was performed on 10 cadaveric specimens.
- The technique avoids dividing the temporalis muscle or performing interfacial dissection.
- Key metrics included exposure, procedure length, and ease of application.
Main Results:
- The Agnes Fast craniotomy was successfully performed in all specimens, preserving the temporalis muscle and its attachments.
- The procedure was completed in under 5 minutes, with intact fascial nerve branches.
- The technique provided comparable exposure to standard pterional craniotomy.
Conclusions:
- The Agnes Fast craniotomy is a fast, simple, and effective modification of the pterional approach.
- It allows for complete preservation of the temporalis muscle and its neurovascular supply.
- This technique is highly suitable for emergent neurosurgical settings.
