Neurology and Neurosurgery: Current Research

Volume 2, Issue 1 (2021)

Research Article - Open Access
Minimally Invasive Surgical Treatment vs. Classic Pterional Craniotomy in Ruptured Intracranial Aneurysms of the Anterior Circulation

J Javier Cuellar-Hernandez*, J Ramón Olivas-Campos, Paulo M Tabera-Tarello and Alan Valadez-Rodriguez

Departments of Neurosurgery, Northeast National Medical Center, Monterrey, Nuevo Leon, Mexico. Av. Lincoln y Fidel Velázquez s/n, colonia Nueva Morelos, ZIP 64180, Monterrey México.

*Corresponding Author:
J Javier Cuellar-Hernandez MD
Departments of Neurosurgery, Northeast National Medical Center, Monterrey, Nuevo Leon, Mexico. Av. Lincoln y Fidel Velázquez s/n, colonia Nueva Morelos, ZIP 64180, Monterrey México.
E-mail: javiercueher@gmail.com

Received date: February 26, 2021; Accepted date: March 15, 2021; Published date: March 22, 2021

Citation: Cuellar-Hernandez jj, Campos JRO, Tarello PMT, Rodriguez AV, (2021) Minimally Invasive Surgical Treatment vs. Classic Pterional Craniotomy in Ruptured Intracranial Aneurysms of the Anterior Circulation. Neurol Neurosurg Curr Res. 2021;2(1):1-7.

Copyright: © 2021 Cuellar-Hernandez jj, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: The objective of the treatment of intracranial aneurysms is complete, permanent and safe occlusion, obtaining the definitive exclusion of the aneurysm from the cerebral circulation. The pterional craniotomy is the most used; we also have safe and effective minimally invasive techniques.

Objective: To determine the prognostic factor of minimally invasive surgical treatment against classic pterional craniotomy in ruptured intracranial aneurysms of the anterior circulation.

Materials and Methods: Descriptive, observational, analytical study. UMAE 25 IMSS patients from January 2019 to July 2020 treated with classic pterional craniotomy and minimally invasive craniotomy for clipping of ruptured intracranial aneurysms of anterior circulation, surgical time, trans-surgical bleeding, trans-surgical rupture index, presence of CSF fistula, were evaluated, wound infection and days in ICU. Descriptive, comparative statistical analysis, test of X2 and U de Mann.

Results: 50 patients were evaluated, 25 with traditional technique and 25 with minimally invasive, CSF fistula was presented in 2 patients with minimally invasive surgery and 4 with classic pterional craniotomy (p=0.32), infection in the wound in classic pterional craniotomy was 10% and in the minimally invasive 4% (p=0.55), in the minimally invasive treatment bleeding was 150 ml and in the classic pterional craniotomy 500 ml (p=0.001). The mean surgical time in surgery in the minimally invasive was 120 minutes and in the classic pterional 160 minutes (p=0.017). Stay in ICU for the minimally invasive procedure, median of 3, the traditional procedure, median of 4 days, (p=0.143).

Conclusion: Minimally invasive surgery offers a satisfactory aneurysmal occlusion rate, shorter surgical time, less bleeding, shorter stay in the ICU and a lower rate of post-surgical complications.

Keywords

Aneurysms, classic pterional craniotomy, minimally invasive surgery.