Unique Craniotomy for Aneurysms of the Cerebral Arterial Circle

Unique Craniotomy for Aneurysms of the Cerebral Arterial Circle

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Rafael Avendaño-Pradel
César Jiménez-Castro
Juan Montoya-Martínez
José Chávez-Monter
Yarel Barba-Ruiz
Edgardo Ruiz-García
Gustavo Vázquez-Morales
Carlos Castillo-Rangel


The objective of the study was to describe our surgical and technical experience by reporting a series of 51 aneurysms treated by a pterional craniotomy as a unique approach for aneurismatic lesions of the cerebral arterial circle (Willis polygon). Retrospective study that reports a series of 37 patients (25 females and 12 males) with diagnosis of aneurismatic lesions from different localization in the Willis polygon from January 2012 to March 2015. Fifty one (51) aneurismatic lesions were treated by a unique pterional craniotomy, including 8 cases of multiple aneurismatic disease and 9 giant aneurysms. Every lesion was clipped by the same pterional modified approach. Every step of this procedure was described and illustrated sequentally. This analysis establishes that the modified frontotemporoesfenoidal (pterional) craniotomy allows surgical access to the clipping of these vascular lesions, from the circle of Willis which correlates with previous evidence. The detailed description of the surgical technique promotes a proper understanding of surgical anatomy and allows playback of this technique.


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