An Official publication of The Asian Congress of Neurological Surgeons (AsianCNS)

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Year : 2010  |  Volume : 5  |  Issue : 2  |  Page : 63


Date of Web Publication11-Aug-2011

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How to cite this article:
. Comments. Asian J Neurosurg 2010;5:63

How to cite this URL:
. Comments. Asian J Neurosurg [serial online] 2010 [cited 2020 Jul 3];5:63. Available from:

Middle cerebral artery aneurysms are common neurosurgical problem. Surgery on these aneurysms can sometimes be quite tricky and also dangerous. Wide base, large size and irregular dome are aneurysm related factors that can affect conduct of surgery. Wide exposure, diligent isolation of perforators, prevention of vessel kinking and obliteration and selection of the most appropriate clip are essential for success. More extensive the subarachnoid hemorrhage, more friable is the aneurysm and the chances of intraoperative bleed are higher. The preoperative neurological grade can also determine the course of surgery. Surgery in a patient having hemiplegia is much more difficult when compared to a patient who is neurologically intact. The thinness of the wall of the aneurysm and the extent of vasospasm will vary with the clinical grade of the patient. Majority of these aneurysms are located at the bifurcation or trifurcation of the middle cerebral artery. Pre-bifurcation aneurysms, as reported by the authors, are relatively rare. The intimacy with perforators makes surgery on these aneurysms more challenging. The authors have a large experience with aneurysm surgery. This experience with this unique group of aneurysm will certainly be useful.


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