Surgical treatment of internal carotid bifurcation and pericallosal artery aneurysms with unilateral

Abstract

Aim: Aneurysms are one of the primary reasons of subarachnoid hemorrhage. The most common aneurysms are the solitary aneurysms. In the same time multiple aneurysms may be seen. Material and Method: Fifty five years old woman who underwent one month ago because of ruptured left internal carotid artery aneurysm was admitted to hospital for surgical treatment of incidental left internal carotid bifurcation and pericallosal artery aneurysms. Results: During surgical treatment, a modified pterional skin incision was planned starting from contrlateral pupilla level at the point hairy skin area and extending curvelinearly to the ipsilateral pterional region. This modified craniotomy permitted to do pterional craniotomy and left paramedian craniotomy in the same time. Pterional craniotomy was done fırstly. Sylvian dissection was performed to reaching down the aneurysmatic dilatation at the location of internal carotid artery bifurcation. Aneurysm was dissected and clipped. Secondly right paramedian frontal craniotomy was performed. Inter-hemisferic approach was done in the clipping of the pericallosal aneurysm. Discussion: In such cases the frontopterional skin incision (a modification of pterional incision) may be used in the performing of pterional and paramedian frontal craniotomy.