Microsurgical treatment of anterior circulation aneurysms via pterional approach: an efficacy and complication analysis

Objective To explore the efficacy and complications of microsurgical treatment of anterior circulation aneurysms via pterional approach.Methods The clinical data of 61 patients with intracranial aneurysms,diagnosed in our hospital from January 2002 to January 2012,were collected; their outcomes and complications were analyzed.Results Clipping was performed in 60 arterial aneurysms and bundling in 3 aneurysms.Fifty patients (81.97％) got good recovery accompanied by 5 having postoperative contralateral hemiplegia,4 epilepsy,1 vegetative state and 1 death.The DSA of 38 aneurysms and CTA of 14 aneurysms after the surgery confirmed that the aneurysms disappeared and the parent arteries restored patency.The postsurgical review (1-12 months after the surgery) showed that 7 patients had mental disorders,8 had temporalis muscle atrophy,and 3 had hydrocephalus and ventriculo-peritoneal shunt was performed.Seven patients formed deep vein thrombosis cured after anticoagulant therapy.Five patients had arterial nerve paralysis,being good recovery after 6-12 months.Two patients had ptosis.One had intracranial infection and 1 cerebral infarction.Conclusion Excision or clipping the intracranial anterior aneurysms under direct vision by microscopy technique is an effective way; early surgery can reduce the incidence of complications. Key words: Anterior circulation aneurysm; Pterional approach; Microsurgery