Interhemispheric Approach for ACom Aneurysm

Abstract

  The operative approaches for ACom Aneurysms include the pterional approach and the interhemispheric approach, and we have used the latter approach in all of our cases. The interhemispheric approach appears to be useful in observing all vascular structures around the ACom complex, and to allow the neck of the aneurysm to be clipped in the ideal closure line. It is not easy to dissect the interhemispheric fissure, because visualizing the arachnoid trabeculae between the pia mater and the vessels can be complicated. The fissure can be separated without pial injury by identifying the microstructure surrounding the major vessels in the pericallosal cistern and the cutting the arachnoid trabeculae. The author describes technical points of interhemispheric approach.