Superolateral Orbital Rim Craniotomy for Middle Cerebral Artery Aneurysms

다국어 초록 (Multilingual Abstract)

Objective : Recently, several approaches for middle cerebral artery aneurysms (MCA) have been developed from conventional method, that is pterional approach. However, the literatures contain no report about minimally invasive surgery for the treatment of MCA aneurysms. So the purpose of our study is to describe a new technique, that is superolateral orbital rim craniotomy (SLORC) approach-minimally invasive surgery and the outcome for the treatment of MCA aneurysms.
Methods : A retrospective review of 12 patients with MCA aneurysms ruptured or unruptured who were operated by SLORC approach was performed during October 1999 thru December 2001.
Results : All the aneurysms were clipped successfully. The mean aneurysm size was 6.8 mm ranged from 4 to 15 mm. The average hospital stay was 15.9±9.1 days and the operation time usually consumed 3 to 4 hours. No patients died and adverse effects directly related with surgery were minimal. Cosmetic result was also achieved just a few days after operation. We never used lumbar drain or extraventricular drainage. During operation, less retraction of neural structure and no transfusion were required. The modified Rankin scores at discharge and 6 months afterwards revealed 0 grade in all assessed patients.
Conclusion : The SLORC is a newly developed procedure for neurosurgeon to treat MCA aneurysms. Although this technique is not widely used, it is likely that this minimally invasive approach will become a promising operative technique in the future.