P2 ANEURYSM APPROACHED VIA THE TEMPORAL HORN - TECHNICAL CASE-REPORT

OBJECTIVE AND IMPORTANCE: We report the use of a transcortical transve ntricular approach to a P2 aneurysm, which was located near the choroi dal fissure, protruded into the temporal horn, and was considered to b e too difficult to approach by the conventional subtemporal route. CLI NICAL PRESENTATION: An 81-year-old woman suddenly developed severe hea dache with vomiting and subsequently lost consciousness, Computed tomo graphic scans revealed a diffuse intraventricular hemorrhage and subar achnoid hemorrhage, Cerebral angiography disclosed a saccular aneurysm in the right P2 segment. INTERVENTION: On the 16th day after admissio n, successful neck clipping was easily performed through the temporal horn via the inferior temporal gyrus. The postoperative course was une ventful. CONCLUSION: This special approach may be preferable in such c ases, because it protects the brain from the detrimental effects of st rong temporal retraction and provides a wider working space.