A temporal approach to anterior communicating artery aneurysms. Technical note

Area of Science:

• Neurosurgery
• Vascular Neurosurgery
• Cerebrovascular Surgery

Background:

• Anterior communicating artery (ACoA) aneurysms are complex cerebrovascular lesions.
• Traditional surgical approaches include pterional, gyrus rectus, and parasagittal frontal fossa routes.
• These methods may involve significant brain retraction and limited surgical control.

Purpose of the Study:

• To describe and evaluate a novel temporal fossa surgical approach for treating ACoA aneurysms.
• To highlight the advantages of the temporal approach compared to standard frontal fossa techniques.

Main Methods:

• A retrospective review of 20 consecutive ACoA aneurysm surgeries utilizing the temporal fossa approach.
• Detailed description of the surgical technique, emphasizing key anatomical landmarks and procedural steps.
• Comparison of outcomes with historical data from gyrus rectus approaches.

Main Results:

• The temporal fossa approach facilitated less brain retraction compared to frontal methods.
• Improved surgical orientation and earlier control of the A1 segments of the anterior cerebral artery were achieved.
• Minimal resection of brain tissue was required, potentially reducing neurological deficits.

Conclusions:

• The temporal fossa approach represents a viable and advantageous alternative for surgical management of ACoA aneurysms.
• This technique offers improved surgical ergonomics, safety, and potentially better patient outcomes.
• Further studies are warranted to validate these findings in a larger cohort.