Tratamento cirúrgico dos aneurismas da circulação anterior

Objectives: A critical analysis about the current methodology used for the treatment of the anterior circulation aneurysms is performed by the authors, emphasizing the importance of the real knowledge about the anatomy of this complex area for adequate surgical procedures. Methods: Some topics about surgical and endovascular procedures for the treatment of aneurysms are discussed, analyzing the indications and complications of them. Results: A large analysis about the aneurysms of the anterior circulation is performed and discussed, considering some aspects like localization, classification and options for the treatment. The paraclinoidal aneuryms were the most difficult ones to be treated. Conclusion: The pterional approach was chosen in the majority of the patients and when giant aneurysms are in focus, the bypass performed by a venous graft between the external carotid and the middle cerebral artery could be a good option before aneurysm exclusion.