Entry Point to the Sylvian Fissure for the Pterional Transsylvian Approach in Aneurysmal Subarachnoid Hemorrhage
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- Category: Vol. 84, June 2016
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Entry Point to the Sylvian Fissure for the Pterional Transsylvian Approach in Aneurysmal Subarachnoid Hemorrhage, MOHAMED A. GABR, NASSER F. EL-GHANDOR, KHALED S. ANBAR, AMR EL-TAYEB and AHMED ZAATER
Abstract
Background: Although the anatomy of the Sylvian fissure is understood, there is little information where to start its dissection in the Pterional Transsylvian (PT-TS) approach.
At small craniotomy using the PT-TS approach, we set the entry point to the Sylvian fissure at 15mm behind the anterior edge of the craniotomy along the Sylvian fissure and designated this site “point 15.” Here we compared the utility of point 15” with the Sylvian point (point on the Sylvian fissure giving rise to the horizontal and anterior ascending rami) that had been recommended earlier as the entry site for opening the Sylvian fissure.
Material and Methods: This study includes 15 patients with ruptured anterior circulation aneurysms. We evaluated the usefulness of “point 15” in the PT-TS approach for aneu-rysmal neck clipping with respect to the adequacy of anatom-ical exposure and low invasiveness.
Results: In 8 patients “point 15” provided for excellent anatomical exposure of the Sylvian fissure; complete neck clipping was possible with minimal brain retraction and damage.
Conclusions: The “point 15” was an easily set entry point to the Sylvian fissure. It provided for sufficient anatomical exposure at surgery for anterior circulation aneurysms.