Dolenc Approach for the Craniotomy Clipping of a Carotid-Ophthalmic Giant Aneurysm: A Case Report

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A 66-year-old woman presented with severe headache. The angiography suggested a carotid–ophthalmic giant aneurysm. The size is 10.4 mm × 9.4 mm × 8.6 mm, and the neck width is 5.7 mm.

Dolenc's approach was performed to clip the aneurysm.

One day postoperatively, the patient was awake, and coordinated with the physical examination. The ocular movement is normal. And the patient also presented with middle tongue extension, and symmetrical nasolabial sulcus. Two days postoperatively, CT scan showed that there was no bleeding in the operation area and local bone defect was observed in the lateral skull base. CTA suggested that the aneurysm disappeared, and the internal carotid artery was unobstructed.

The transcavernous approach, as initially described by Dolenc, is a useful technique for microsurgical clipping of carotid–ophthalmic aneurysms.