Keyhole-approaches for surgical treatment of cerebral aneurysms of anterior circulation

Objective. to present the preliminary experience of differentiated strategy for the usage of various keyhole approaches for the treatment of anterior circulation aneurysms. Material and methods. Authors operated 90 patients with 95 aneurysms of anterior circlulation from 2014 to March 2016. The majority of patients had unruptured aneurysms (62 patients). Subarachnoid hemorrhage (SAH) was observed in 28 patients, among them 18 patients were operated on in the acute period of SAH. The severity of state of all patients with SAH was assessed as I and II stage according to Hunt-Hess scale and intensity of SAH was 1-2 by Fisher scale. The choice of surgical approach was determined after accurate assessment of intracranial structures and aneurysms anatomy. Results: All aneurysms were completely excluded from the cerebral blood flow. No serious complications or deaths were observed in examined group. Conclusion. The progress of minimally invasive procedures and adequate selection of patients for operation allow significantly lowering the surgical trauma, the number of associated complications and incidence of adverse cosmetic effects. The fast recovery of patients and shortening the in-hospital stay period alongside with the social adaptation after neurosurgical procedures is the priority direction nowadays.

супраорбитальный доступ, keyhole, трансорбитальный доступ, мини-птериональный доступ, церебральные аневризмы, supraorbital approach, keyhole, transorbital approach, minimal pterional approach, cerebral aneurysms

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