Keyhole Approach in Cerebral Aneurysm Surgeries

Area of Science:

• Neurosurgery
• Cerebrovascular Surgery

Background:

• Standard pterional and interhemispheric approaches are gold standards for clipping anterior circulation cerebral aneurysms.
• While endovascular treatments are common, surgical clipping remains indicated for certain aneurysm subsets.
• Technological advancements have introduced less invasive techniques like the keyhole approach.

Purpose of the Study:

• To discuss the surgical indications, preoperative simulation, techniques, and comparative advantages and disadvantages of the keyhole (supraorbital) approach for clipping cerebral aneurysms.
• To highlight the importance of selecting appropriate cases for keyhole clipping.

Main Methods:

• Review of surgical indications for keyhole clipping of cerebral aneurysms.
• Discussion of preoperative simulation techniques.
• Description of keyhole surgical techniques.
• Analysis of the pros and cons of the keyhole approach compared to standard craniotomies.

Main Results:

• Keyhole clipping is a viable, less invasive alternative for select cerebral aneurysms.
• Successful application depends on careful preoperative assessment and appropriate case selection.
• The choice between standard craniotomy and keyhole craniotomy should be guided by aneurysm-specific factors.

Conclusions:

• Keyhole clipping is a valuable technique for specific anterior circulation cerebral aneurysms.
• Definite surgical indications, based on aneurysm characteristics, are essential for safe and effective keyhole clipping.
• This approach complements traditional open surgical methods, offering a minimally invasive option.