Clipping via the Transsylvian Approach:From Basic to Advanced Surgical Techniques

The transsylvian approach is one of the most commonly used approaches in neurosurgery and is essential for clipping aneurysms located in the anterior cranial circulation, such as the middle cerebral artery, internal carotid artery, and anterior communicating artery. Moreover, basilar artery aneurysm...

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Bibliographic Details
Published inNō shinkei geka Vol. 52; no. 5; p. 946
Main Author Ono, Hideaki
Format Journal Article
LanguageJapanese
Published Japan 01.09.2024
Subjects
Humans
Intracranial Aneurysm - surgery
Neurosurgical Procedures - methods
Surgical Instruments
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Summary:The transsylvian approach is one of the most commonly used approaches in neurosurgery and is essential for clipping aneurysms located in the anterior cranial circulation, such as the middle cerebral artery, internal carotid artery, and anterior communicating artery. Moreover, basilar artery aneurysms can be clipped using this approach, albeit with some modifications. Important tips for dissecting the Sylvian fissures include reliable visualization, anatomical recognition, and steady manipulation. The actual steps are as follows: determine the affiliation of the arteries and veins, gently move the brain to create a wide space, cut the arachnoid mater, and follow the course of the arteries. In case of subarachnoid hemorrhage, irrigation and flushing out the hematoma is the key step involved in recognizing the structure and safely performing surgery. Here, we describe the basic key operative techniques for performing clipping via the transsylvian approach.
ISSN:0301-2603
DOI:10.11477/mf.1436205004