[Neck Clipping via Subtemporal Approach].

Area of Science:

• Neurosurgery
• Vascular Neurosurgery
• Surgical Neurology

Background:

• The subtemporal approach is a neurosurgical technique offering broad anteroposterior surgical visualization.
• It provides excellent access to the proximal basilar artery, crucial for treating complex cerebrovascular pathologies.
• Adaptation via a tentorial incision, the subtemporal transtentorial approach, facilitates treatment of low-lying aneurysms.

Purpose of the Study:

• To highlight the benefits and risks of the subtemporal approach in neurosurgery.
• To describe the subtemporal transtentorial approach for managing low-positioned aneurysms.
• To outline critical measures for mitigating temporal lobe injury during subtemporal surgery.

Main Methods:

• Review of the anatomical advantages and surgical considerations of the subtemporal approach.
• Discussion of modifications like the transtentorial incision for specific aneurysm locations.
• Emphasis on neuroprotective strategies during temporal lobe retraction.

Main Results:

• The subtemporal approach ensures a wide surgical field and direct access to the proximal basilar artery.
• The subtemporal transtentorial variant effectively addresses low-positioned aneurysms.
• Risk mitigation strategies are essential for preventing temporal lobe damage.

Conclusions:

• The subtemporal approach is valuable for proximal basilar artery aneurysms, especially when adapted with a transtentorial incision.
• Meticulous surgical technique, including patient positioning and cerebrospinal fluid management, is paramount.
• Preservation of bridging veins and controlled temporal lobe retraction are key to minimizing neurological deficits.