Retractorless combined pterional and interhemispheric approach to achieve proximal control in pericallosal artery aneurysm: how I do it

Abstract

Background: Pericallosal artery aneurysms differ from other cerebral aneurysms for the difficulty in establishing proximal vascular control during surgical clipping. A frontomedial craniotomy with combined pterional and interhemispheric approach allows obtaining a better proximal control.

Materials and methods: We present our surgical technique to achieve a proximal vessel control in pericallosal artery aneurysm clipping using a combined pterional and interhemispheric approach through frontomedial craniotomy. This surgical technique is illustrated by an intraoperative video.

Conclusion: Proximal control for pericallosal artery aneurysm clipping can be challenging. In selected cases, a single craniotomy allows performing two approaches and obtaining a safer proximal control for surgical clipping.

Keywords: Interhemispheric approach; Pericallosal aneurysm; Proximal control; Pterional approach.