ABSTRACT
Aneurysms arising from the anterior communicating artery complex present the surgeon
with certain difficulties. These are related specifically to the complex anatomy and
the frequent vascular anomalies that characterize this region. It is only through
a critical study of the preoperative angiographic findings that a sound surgical approach
can be selected.
The most common approach is naturally the transsylvian lateral subfrontal approach.
There are several factors that determine choice of laterality. In addition, complex
shape, size, height above the planum, and redo surgeries often imply a need for a
skull base cranio-orbital approach, to minimize brain retraction and maximize visualization.
In the following article we will review techniques and pitfalls, and illustrate the
management of five different cases with unique challenges.
KEYWORD
Anterior communicating artery aneurysms - surgical anatomy - skull base surgery