Anterior Communicating Artery Aneurysm Surgery: Which Is The Most Appropriate Head Position?

ÖZDEMİR M., CÖMERT A., UĞUR H. Ç., KAHILOĞULLARI G., Tubbs R. S., Egemen N.

JOURNAL OF CRANIOFACIAL SURGERY, vol.25, no.6, pp.2205-2208, 2014 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 25 Issue: 6
  • Publication Date: 2014
  • Doi Number: 10.1097/scs.0b013e3182a30ea3
  • Journal Name: JOURNAL OF CRANIOFACIAL SURGERY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.2205-2208
  • Keywords: Anatomy, cadaver, intracranial aneurysm, cerebral hemorrhage, subarachnoid hemorrhage, MICRONEUROSURGICAL MANAGEMENT, INTERHEMISPHERIC FISSURE, PTERIONAL APPROACH, DISSECTION, ANATOMY, RUPTURE, COMPLEX
  • Ankara University Affiliated: Yes

Abstract

Head positioning and the degree of rotation for anterior communicating artery aneurysm surgery is controversial. With this anatomic study, we aimed to give a broad description of head positioning for various aneurysm dome projections. In addition, with the use of a corrosion-cast technique, a three-dimensional arterial tree was demonstrated, an anterior communicating artery region aneurysm model was prepared, and pictures were taken at various angles. According to our observations, 30-degree head rotation was found to be the most suitable position for the anterior and superior projected aneurysms. For posterior projection, aneurysm neck was best viewed with 15-degree head rotation. Aneurysms projecting inferiorly necessitated the greatest rotation at 45 degrees. Each aneurysm dome projection of the anterior communicating artery aneurysm should be individually considered, and the head position should be adjusted accordingly. The use of appropriate head positions during surgery will prevent the development of postoperative ischemic complications and will increase the success of surgery by preventing unnecessary tissue manipulation.