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Interhemispheric Approach for Ruptured Anterior Communicating Artery Aneurysms Tomoya KAMIDE 1 1Department of Neurosurgery, Kanazawa University Keyword: 破裂前交通動脈瘤 , 経大脳半球間裂アプローチ , 安全確実な脳動脈瘤手術 , ruptured anterior communicating artery aneurysm , interhemispheric approach , safe and reliable cerebral aneurysm clipping pp.957-966
Published Date 2024/9/10
DOI https://doi.org/10.11477/mf.1436205005
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 The interhemispheric approach is very useful for the safe and reliable clipping of ruptured anterior communicating aneurysms. This approach enables surgeons to directly visualize the aneurysm and the surrounding vessels, including perforators, and provides a wide surgical corridor for clip insertion from multiple directions. Furthermore, in challenging situations, this approach facilitates vascular reconstruction without the need for graft harvesting. However, because of the procedural difficulty, many young and inexperienced neurosurgeons may hesitate to perform this technique. Therefore, this study aimed to provide useful tips, based on intraoperative photography, for skin and dural incisions, prevention of cerebrospinal fluid leakage and olfactory impairment, and fundamental steps for opening tight interhemispheric fissures. Finally, representative challenging cases that were adequately managed using the advantages of this approach are presented.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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