The modified pterional keyhole craniotomy for open cerebrovascular surgery: A new workhorse? Journal Article


Authors: Mocco, J.; Komotar, R. J.; Raper, D. M. S.; Kellner, C. P.; Connolly, E. S.; Solomon, R. A.
Article Title: The modified pterional keyhole craniotomy for open cerebrovascular surgery: A new workhorse?
Abstract: Background The frontotemporal craniotomy is the most commonly used approach for vascular neurosurgery. However, this approach requires significant mobilization of overlying soft tissues, resulting in muscle atrophy and temporomandibular joint pain. We describe a modified pterional keyhole approach and its use in our initial clinical experience. Patients and Methods Eleven consecutive minimally invasive pterional keyhole approaches were used for 14 aneurysms. Patient demographics, aneurysm characteristics, and morbidities were prospectively collected. Results Mean aneurysm size was 6.5 mm, and all were in the anterior circulation. All aneurysms were successfully clipped, with no occurrence of intraoperative rupture or perforator occlusion. There were no incidences of frontalis nerve injury. No technical difficulties or limitation to aneurysm access were experienced. Conclusion In carefully selected patients, a minimally invasive keyhole approach may be a safe and effective alternative to traditional pterional craniotomy for certain anterior circulation aneurysms. © 2013 Georg Thieme Verlag KG Stuttgart · New York.
Keywords: adult; clinical article; aged; surgical technique; follow up; prospective study; nerve injury; surgery; craniotomy; headache; postoperative pain; minimally invasive; muscle atrophy; intracranial aneurysm; clipping; keyhole approach; brain artery aneurysm; cerebrovascular surgery; minimally invasive pterional keyhole approache
Journal Title: Journal of Neurological Surgery. Part A: Central European Neurosurgery
Volume: 74
Issue: 6
ISSN: 2193-6315
Publisher: Thieme Publishing  
Date Published: 2013-11-01
Start Page: 400
End Page: 404
Language: English
DOI: 10.1055/s-0032-1333130
PROVIDER: scopus
PUBMED: 23427039
DOI/URL:
Notes: --- - "Export Date: 2 December 2013" - "Source: Scopus"
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  1. Ricardo Jorge Komotar
    13 Komotar