J Neurol Surg A Cent Eur Neurosurg 2013; 74(01): 018-024
DOI: 10.1055/s-0032-1326944
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Contralateral Approach to Unruptured Superior Hypophyseal Artery Aneurysms

Sifang Chen
1   Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
,
Y. Kato
2   Department of Neurosurgery, Fujita Health University Hospital, Dengakugakubo, Kutsukake, Toyoake, Aichi, Japan
,
Ashish Kumar
3   Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, India
,
Rohan Sinha
4   Department of Neurosurgery, St. Stephen's Hospital, Delhi, India
,
Daikichi Oguri
2   Department of Neurosurgery, Fujita Health University Hospital, Dengakugakubo, Kutsukake, Toyoake, Aichi, Japan
,
Jumpei Oda
2   Department of Neurosurgery, Fujita Health University Hospital, Dengakugakubo, Kutsukake, Toyoake, Aichi, Japan
,
Takeya Watabe
2   Department of Neurosurgery, Fujita Health University Hospital, Dengakugakubo, Kutsukake, Toyoake, Aichi, Japan
,
Shuei Imizu
2   Department of Neurosurgery, Fujita Health University Hospital, Dengakugakubo, Kutsukake, Toyoake, Aichi, Japan
,
Hirotoshi Sano
2   Department of Neurosurgery, Fujita Health University Hospital, Dengakugakubo, Kutsukake, Toyoake, Aichi, Japan
,
Yuichi Hirose
2   Department of Neurosurgery, Fujita Health University Hospital, Dengakugakubo, Kutsukake, Toyoake, Aichi, Japan
› Author Affiliations
Further Information

Publication History

19 June 2011

28 May 2012

Publication Date:
08 November 2012 (online)

Abstract

Objective To evaluate the feasibility and limitations of the contralateral approach to unruptured superior hypophyseal artery (SHA) aneurysms.

Methods Data regarding eight cases of superior hypophyseal artery aneurysms operated on by a contralateral pterional approach at our center from January 2008 to September 2010 were collected and evaluated retrospectively. Of these eight cases, six were male and two were female. The mean age was 57.1 years (range 28 years to 77 years). All the aneurysms were unruptured; five were on right side and three were on left side. The surgical technique and outcome of patients were reviewed.

Results All aneurysms were successfully clipped without complication and patency of all superior hypophyseal arteries was preserved. Postoperative three-dimensional computed tomography angiography revealed residual aneurysm in only one case. None of the patients had deterioration of visual acuity or field after surgery. The contralateral pterional approach was found to be appropriate for fully exposing the aneurysmal dome and neck without retraction of the optic nerve or the carotid artery in five cases. Slight retraction of the optic nerve was required in two cases, and significant manipulation of the optic nerve was required in one case.

Conclusions The contralateral pterional approach for clipping of unruptured superior hypophyseal artery aneurysms is technically feasible and safe in a select group of patients where optimal results can be achieved without significant retraction of near by neurovascular structures.

 
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