Operative Approach to the M₁ Portion Aneurysm of Middle Cerebral Artery

Abstract

It seems that the ordinary approach is best in the direct treatment of middle cerebral artery aneurysms. But, sometimes, it is very dangerous with some special types of aneurysms which project rostrally or laterally and/or are attached to the dura mater. The procedure may cause premature rupture, due to retraction of the frontal lobe and the middle cerebral artery itself.
The distal approach is best suited for such types of aneurysms.
But then, we prefer to use the superior approach, by which we are able to treat the aneurysmal neck easily with safety without any brain damage, to the usual type of aneurysm.
The selection of the approach is based on a lateral view of the CAG. If the aneurysmal shadow is obviously rostral from M₁ and origin of M₂ branches, the distal approach should be selected.
The only indication for the ordinary approach is on aneurysm of early bifurcation of the middle cerebral artery.