ANATOMICAL AND TECHNICAL ASPECTS OF THE CONTRALATERAL APPROACH FOR MULTIPLE ANEURYSMS

Microsurgery of multiple aneurysms is still a controversial subject. I n order to avoid the risk of rebleeding and the consequent increase in morbidity in such cases all aneurysms or at least as many aneurysms a s possible should be treated in the first operative procedure. To reac h that goal aneurysms located on the contralateral side should also be considered for clipping during the first operation. Between 1984 and 1994 a series of 51 patients harboring multiple aneurysms of which 55 aneurysms were located on the contralateral side of the craniotomy wer e operated at our institution. No mortality or morbidity could be dire ctly ascribed to the aneurysm that was clipped contralaterally. Based on that series we have described the anatomical features, technical as pects and surgical difficulties of approaching bilateral aneurysms thr ough the same craniotomy.