经额部微骨孔纵裂入路治疗前交通动脉瘤

目的 总结经额部微骨孔纵裂入路治疗前交通动脉瘤的手术方法。方法 分析8例(9个)前交通动脉瘤患者的手术方法，经额部微骨孔纵裂入路，采用额部中线偏右侧游离小骨瓣，直径约3cm，沿纵裂探查至大脑镰下缘、胼胝体膝部前缘，显露前交通动脉，分离并夹闭动脉瘤颈。结果 8例患者共发现9个前交通动脉瘤，术前H-H分级Ⅰ级1例，Ⅱ级7例，术后均获良好疗效，无手术致残及死亡者。结论 以额部微骨孔纵裂入路治疗前交通动脉瘤较传统的翼点入路损伤小，显露更直接，且在术中可控制双侧大脑前动脉A1段。

Transfrontal interhemispheric key-hole approach in the treatment of anterior communicating artery aneurysm

Objective To introduce a transfrontal interhemispheric key hole approach to clip the aneurysms of anterior communicating artery.Methods A low anterior interhemispheric approach utilizing a right frontal "key hole" craniotomy was made,and the ACoA was exposed through the inferior boarder of the cerebral flax genu of corpus callosum.Results 9 ACoA aneurysms in 8 patients were successfully clipped via transfrontal interhemispheric key hole approach.No severe disability and mortality.Conclusions For clipping the ACoA aneurysm,a transfrontal interhemispheric key hole approach requires less brain retraction,gives better surgical orientation to control both A1 segments before disturbing the aneurysm.