Is eyebrow approach suitable for ruptured anterior circulation aneurysms on early stage: a prospective study at a single institute

Acta Neurochir (Wien). 2009 Jul;151(7):781-4; discussion 784. doi: 10.1007/s00701-009-0205-9. Epub 2009 May 8.

Abstract

Objective: A prospective study was underway to evaluate the outcome of eyebrow keyhole approach for ruptured anterior circulation aneurysms on early stage.

Methods: In the past 4 years, 88 patients with ruptured anterior circulation aneurysms, were operated on early stage by an experienced neurosurgical team through eyebrow craniotomy. The clinical data were analyzed.

Results: Patients with Hunt and Hess Grade I-II (85.2%) or III (14.8%) were selected for eyebrow approach on early stage. All aneurysms were small (20.5%) or middle (79.5%) in size. All but seven (92.0%) aneurysms were clipped successfully. The opening of frontal sinus occurred in 11(12.5%) cases through eyebrow approach. Of all, 78 (88.6%) patients achieved favorable outcomes.

Conclusions: Eyebrow keyhole approach for ruptured anterior circulation aneurysms on early stage might be in particular selected according to the Hunt and Hess Scale, the projection of aneurysm, the length of M1 segment, the location of cerebral hematoma, the size and complexity of aneurysm, as well as the preference and experience of the neurosurgical team.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Brain / blood supply
  • Brain / surgery
  • Carotid Artery, Internal, Dissection / diagnostic imaging
  • Carotid Artery, Internal, Dissection / pathology
  • Carotid Artery, Internal, Dissection / surgery
  • Circle of Willis / diagnostic imaging
  • Circle of Willis / pathology
  • Circle of Willis / surgery
  • Craniotomy / methods*
  • Dura Mater / anatomy & histology
  • Dura Mater / surgery
  • Eyebrows / anatomy & histology*
  • Female
  • Frontal Bone / anatomy & histology
  • Frontal Bone / surgery*
  • Frontal Sinus / anatomy & histology
  • Frontal Sinus / surgery
  • Glasgow Outcome Scale
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / pathology
  • Intracranial Aneurysm / surgery*
  • Intraoperative Complications / etiology
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Neurosurgical Procedures / methods
  • Prospective Studies
  • Radiography
  • Treatment Outcome