2019 年 47 巻 2 号 p. 85-89
The need of minimally invasive surgeries for unruptured cerebral aneurysms remains unclear. Between 2010 and 2016, 75 patients with unruptured cerebral small aneurysms underwent direct neck clipping via the distal trans-sylvian keyhole approach by the first author. After the surgery, all patients recovered well without any neurological deterioration. Compared to patients who underwent conventional craniotomy, those who underwent keyhole surgery tended to be more satisfied in terms of postoperative pain and cosmetic results. Furthermore, keyhole surgery was found to be associated with less postoperative temporal muscle atrophy. Our keyhole technique provides an important contribution to the list of less invasive surgical procedures for unruptured cerebral aneurysms.