Indications • Clipping of distal anterior cerebral artery (DACA) aneurysms has a long-lasting effect; rerupture of previously clipped aneurysm is very rare. • DACA aneurysms are usually small, with a…
Indications • We prefer surgical clipping of most ruptured and unruptured middle cerebral artery (MCA) aneurysms because of the accessibility of their location and the relatively low morbidity and durability…
Indications Absolute • Subarachnoid hemorrhage with intraparenchymal hemorrhage requiring emergent evacuation • Subarachnoid hemorrhage with anterior communicating artery (Acomm) aneurysm not repairable by endovascular coiling Strong • Large aneurysm (≥10…
Indications Absolute • Subarachnoid hemorrhage with intraparenchymal hemorrhage requiring emergent evacuation • Subarachnoid hemorrhage with posterior communicating artery (Pcomm) aneurysm not repairable by endovascular coiling Strong • Large aneurysm (≥10…
Indications • The retrolabyrinthine approach is a hearing-preserving presigmoid approach that uses a mastoidectomy and skeletonization of the sigmoid sinus to expose the presigmoid dura behind the semicircular canals. •…
Indications • The middle fossa approach is a largely extradural approach to the bony structures that make up the floor of the middle fossa. • Although the convex floor of…
Indications • Transsylvian approaches enter the parasellar cisterns on a superior-to-inferior trajectory, forcing the surgeon to work past the carotid artery through the opticocarotid or carotid-oculomotor triangles to access this…
Indications • The suboccipital approach with C1 laminectomy provides adequate visualization of approximately 270 degrees of the circumference around the medulla. This approach does not provide safe access to the…
Indications • Frontotemporal craniotomy with orbitozygomatic osteotomy is an adjunct to pterional craniotomy that allows greater rostral trajectory to midline structures. By removing the superior and lateral bony orbit, one…
Indications • The unilateral and bilateral subfrontal approaches are the workhorse approaches for access to nearly the entire anterior cranial fossa floor; anterior midline parasellar structures such as the tuberculum…
