{"id":"6c6527e5-d9e4-42e3-a767-7b885501c787","slug":"unilateral-subfrontal-approach-to-anterior-communicating-artery-aneurysms-a-review-of-28-patients-2","title":"Unilateral subfrontal approach to anterior communicating artery aneurysms: A review of 28 patients","authors":["Jorge Marcelo Mura","Esteban Torche","Evandro de Oliveira"],"abstract":"Background: The unilateral subfrontal approach is presented as an alternative to the pterional approach for the treatment of anterior communicating artery aneurysms. This approach has been previously described as the 'superciliar keyhole approach' or the 'lateral supraorbital approach' and is characterized as a 'tailored' pterional approach. The authors discuss its potential advantages and limitations compared to traditional methods. Methods: The article reviews a clinical series of 28 patients who underwent the unilateral subfrontal approach for anterior communicating artery aneurysms. The authors emphasize the importance of microsurgical techniques, such as wide opening of the basal cisterns and fenestration of the lamina terminalis, to facilitate cerebrospinal fluid drainage and brain relaxation during surgery. Results: The authors note that the unilateral subfrontal approach does not avoid significant resection of the gyrus rectus, with 50% resection in unruptured and 61% in ruptured aneurysms. They also highlight that this approach may not be suitable for patients with high-grade subarachnoid hemorrhage due to its limitations in addressing blood clot removal and brain relaxation. Conclusion: While the unilateral subfrontal approach minimizes sylvian dissection and brain manipulation, its efficacy in preventing vasospasm and hydrocephalus remains uncertain. The decision on surgical approach should be based on the surgeon's experience and the specific clinical scenario, considering the relative risks of each technique. Keywords: anterior communicating artery, aneurysms, unilateral subfrontal approach, pterional approach, surgery, subarachnoid hemorrhage, microsurgery","thumbnailUrl":null,"publishDate":"2013-01-18T00:00:00.000Z","doi":"10.4103/2152-7806.106257","categories":["Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/6c6527e5-d9e4-42e3-a767-7b885501c787/pdf"}