This review intended to describe in a didactic and practical manner the frontotemporosphenoidal craniotomy, which is usually known as pterional craniotomy and constitute the cranial approach mostly utilized in the modern neurosurgery. This is, then, basically a descriptive text, divided according to the main stages involved in this procedure, and describes with details how the authors currently perform this craniotomy.
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http://dx.doi.org/10.1590/s0004-282x2012000900015 | DOI Listing |
World Neurosurg
January 2025
Department of Neurological Surgery, St. John's Neuroscience Institute, Tulsa, OK. Electronic address:
Middle cerebral artery (MCA) aneurysms remain excellent candidates for microsurgical treatment, despite proliferation of new endovascular tools. Nonetheless, patients desire less invasive options for permanent, durable treatment of their aneurysms; this is particularly the case for those presenting without subarachnoid hemorrhage, and those with multiple aneurysms that may require several surgical approaches. Keyhole craniotomies, when properly utilized in well-selected patients, allow for minimally invasive treatment of both ruptured and unruptured cerebral aneurysms, including those harboring bilateral aneurysms which may be treated from a single approach.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
The management of multiple intracranial aneurysms presents significant clinical challenges, particularly when complicated by underlying conditions such as cerebral atherosclerosis. This case report highlights the successful treatment of a 66-year-old female diagnosed with three intracranial aneurysms located in the right middle cerebral artery (MCA), pericallosal artery, and M2 segment. The patient also had a history of systemic atherosclerosis and right-sided breast cancer, factors that increased the complexity of surgical intervention.
View Article and Find Full Text PDFActa Neurochir (Wien)
January 2025
Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
Background: The Focused Sylvian Approach (FSA) is a refined, minimally invasive technique for clipping small to medium-sized middle cerebral artery (MCA) aneurysms, prioritizing safety and aesthetics.
Method: The craniotomy remains confined to the superior temporal line, with the incision concealed within the temporal muscle. The Sylvian fissure is carefully dissected to preserve venous structures.
Neurosurg Rev
January 2025
Division of Neurosurgery, Department of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
The mini-pterional craniotomy (mPT) was designed to be a minimally invasive alternative to the standard pterional (PT) approach. However, it remains unclear which technique produces better results. Thus, we aimed to perform a meta-analysis comparing functional, surgical, and aesthetic outcomes between mPT and PT in intracranial aneurysms.
View Article and Find Full Text PDFOper Neurosurg (Hagerstown)
January 2025
Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Background And Importance: Fusiform middle cerebral artery (MCA) bifurcation aneurysms can be challenging to treat with standard endovascular or microsurgical techniques. The in situ side-to-side bypass technique represents an elegant revascularization option for these aneurysms when trapping becomes necessary.
Clinical Presentation: A man in his 50s presented for evaluation of an incidentally found fusiform, 10 mm, right MCA bifurcation aneurysm with involvement of both the inferior and superior M2 trunks.
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