Doing More with LessMinipterional and Supraorbital Keyhole Craniotomies for Ruptured Anterior Circulation Aneurysms: Experience at Single Center

BackgroundKeyhole craniotomy is a type of pterional craniotomy that involves a minimally invasive approach for the treatment of cerebral aneurysms. Currently, the minipterional keyhole craniotomy and supraorbital keyhole craniotomy procedures are frequently performed.MethodsWe evaluated the feasibility and safety of supraorbital keyhole craniotomies and minipterional keyhole craniotomy for the clipping of ruptured intracranial aneurysms in the anterior cerebral circulation as an alternative to the pterional approach in a consecutive series of 25 patients.ResultsThe rate of intraoperative aneurysmal rupture was 8% (2/25), and all ruptures were safely controlled.ConclusionThe success solely depends on careful selection of patients and the experience of the surgical team.