ABSTRACT
Aneurysms arising from the anterior communicating artery complex present the surgeon with certain difficulties. These are related specifically to the complex anatomy and the frequent vascular anomalies that characterize this region. It is only through a critical study of the preoperative angiographic findings that a sound surgical approach can be selected.
The most common approach is naturally the transsylvian lateral subfrontal approach. There are several factors that determine choice of laterality. In addition, complex shape, size, height above the planum, and redo surgeries often imply a need for a skull base cranio-orbital approach, to minimize brain retraction and maximize visualization.
In the following article we will review techniques and pitfalls, and illustrate the management of five different cases with unique challenges.
KEYWORD
Anterior communicating artery aneurysms - surgical anatomy - skull base surgery
