Bifrontal interhemispheric approach for carotid-ophthalmic aneurysms

Area of Science:

• Neurosurgery
• Vascular Surgery
• Cerebrovascular Disease

Background:

• Carotid-ophthalmic aneurysms are complex cerebrovascular lesions.
• Surgical treatment presents significant challenges due to anatomical location.
• Previous approaches offered limited visualization and access.

Purpose of the Study:

• To describe a novel surgical technique for treating carotid-ophthalmic aneurysms.
• To evaluate the efficacy and safety of the interhemispheric approach for these aneurysms.

Main Methods:

• A bifrontal craniotomy was performed, with dissection of the Sylvian and interhemispheric fissures.
• Temporary occlusion of the common and external carotid arteries was employed with cerebral protection.
• Anterior clinoid process and optic canal roof resection were performed when necessary.

Main Results:

• The interhemispheric approach provided a significantly larger operative field and better aneurysm exposure.
• The technique facilitated precise clipping of the aneurysm neck from multiple angles.
• No previous reports of direct surgery using this specific interhemispheric approach were found.

Conclusions:

• The described interhemispheric approach is a safe and effective method for surgical treatment of carotid-ophthalmic aneurysms.
• This technique offers superior visualization and access compared to other surgical approaches.
• Further studies may validate this approach for a wider patient population.