Background and study aims: To explore the usefulness of a unilateral approach for clipping multiple aneurysms including a contralateral paraclinoid aneurysm.
Materials and methods: Between January 2011 and May 2016, the unilateral approach was used to clip a contralateral paraclinoid aneurysm plus additional ipsilateral aneurysms. The records of these patients were analyzed retrospectively.
Results: A total of 27 bilateral aneurysms in 12 patients were clipped successfully via a unilateral pterional craniotomy. All patients showed a good recovery (Glasgow Outcome Scale score: 5). Postoperative digital subtraction angiography or computed tomography angiography did not show any residual aneurysm. Of the three patients with preoperative visual symptoms, two showed improvement. No visual function impairment was observed among the others.
Conclusion: The contralateral approach remains a safe and reliable treatment option for selected paraclinoid aneurysms and allows to clip additional ipsilateral aneurysm(s). Feasibility depends on the type of paraclinoid aneurysm and other specific related features. It is an alternative approach for experienced neurosurgeons.
Georg Thieme Verlag KG Stuttgart · New York.