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Updated: Feb 11, 2026

Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Supraorbital approach through eyebrow skin incision for aneurysm clipping: how I do it
Alessio Chiappini1, Francesco Marchi2, Michael Reinert2
1Department of Neurosurgery, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Via Tesserete 46, 6903, Lugano, Switzerland. alessio.chiappini@icloud.com.
Background:
Surgery has been in a huge development where the aim is to achieve same or better results with less complication in a less invasive way; these minimal approaches can be applied in a very safe way to aneurysmal neurosurgery.
Method:
Images are studied to optimize the patient positioning and the surgical roadmap. After the positioning, the skin incision, craniotomy, and dura incision are performed and intradural lesion is reached. A watertight closure is performed under the microscope.
Conclusion:
The keyhole approach requires some adaption from the side of the surgeon and can be performed only in cases envisioned to have no increased risk for the patient.
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