engleski

Minimally invasive microsurgery in aneurysm treatment

Background: With introduction of coilling in aneurysm treatment there are less number of aneurysms left for microsurgical approach. Objectives: The aim of the study is to present our results and experiences with microsurgical treatment of intracranial aneurysms. Patients and methods: In the period from May 1996 to February 2007, we used keyhole approach in surgical treatment of 910 cases with various intracranial pathology. During the same time 749 patients with 873 aneurysms were operated, and further 78 patients with 84 aneurysms were coiled. The majority of 749 patients with aneurysm were operated through small keyhole craniotomy in different locations (595), and most of them through eyebrow-keyhole craniotomy. The remaining 154 patients were operated using larger craniotomy. Results: Good outcome was achieved in most of the microsurgically treated patients. Excellent or very good outcome was obtained in 83% patients from keyhole craniotomy group, and 79% of patients in standard craniotomy group. The mortality rate in keyhole group was 0, 72%, and in standard craniotomy group 1, 97%. Conclusions: Since introduction of endovascular techniques in aneurysm treatment, conjoined cerebrovascular team decide upon the treatment options individually for each patient with intracranial aneurysm. Keyhole approach with aid of lumbar drainage, endoscopic assistance and evoked potential monitoring is safe and reliable treatment option for intracranial aneurysms. According to our results, microsurgery still have important role in aneurysm treatment.

minimally invasive neurosurgery; keyhole; aneurysm

nije evidentirano