Surgery for Pericallosal Aneurysms

Abstract

Thirty patients with distal anterior cerebral artery aneurysm were operated on microsurgically in the last decade. Our technique has continuously been tailored to comply with the requirements of surgery of these lesions. A contralateral frontoparasagittal craniotomy and dissection of the neck are advised since these have been proved to make premature rupture of the often embedded sac less likely. Careful revision of all remaining arteries serves to prevent ischemic complications. We prefer to clip these aneurysms within 48 h after the first rupture if it has left the patient able to communicate, since fatal or disabling clinical vasospasm as well as early rerupture can be avoided this way.