Efficacy of unilateral craniotomy for clipping bilateral mirror aneurysms of the middle cerebral artery
Li Yuanchao
Zhang Guodong
Zhang Jiaqi
Cheng Zhenguo
Lan Yanping
Abstract：Objective To investigate the feasibility of unilateral craniotomy for clipping bilateral mirror aneurysms of the middle cerebral artery(MCA)and the value of neuroendoscopy in this procedure.Methods Clinical data of 13 patients with bilateral mirror aneurysms of the MCA were analyzed retrospectively.The use of endoscopy,operative time,presence of residual aneurysm neck on the contralateral side at 3 months postoperatively,and Glasgow Outcome Scale(GOS)scores were recorded for each case.Results Nine patients underwent successful clipping of the contralateral aneurysm in a single-stage unilateral craniotomy,including 4 under microscope alone and 5 with endoscope-assisted microsurgery.Four patients required a second-stage operation due to failure in the first-stage procedure.Among the successful single-stage unilateral craniotomy cases,postoperative computed tomography angiography(CTA)at 3 months revealed no residual aneurysm neck in 6 cases(2 under microscope alone and 4 with endoscope-assisted microsurgery),while 3 cases had residual aneurysm neck(2 under microscope alone and 1 with endoscope-assisted microsurgery).The operative time was(171.0±9.2)minutes for simple microsurgery and(179.3±6.6)minutes for endoscope-assisted microsurgery,indicating no significant increase in operative time with neuroendoscopy.The GOS scores at 3 months postoperatively were 5 in 11 cases and 4 in 2 cases.Conclusions Unilateral craniotomy for clipping bilateral mirror aneurysms of the MCA is feasible,and the use of neuroendoscopy can enhance surgical outcomes.
Keywords：intracranial aneurysmsmiddle cerebral arteryneuroendoscopy
Publication Date：2024-07-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 396-399 )