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Clipping and STA-MCA bypass for unruptured AcomA aneurysm associated with unilateral MCA occlusion.

The authors show a surgical technique of clipping in conjunction with superficial temporal artery (STA)-middle cerebral artery (MCA) bypass to treat unruptured anterior communicating artery (AcomA) aneurysm associated with unilateral MCA occlusion. First, through MCA occlusion side, fronto-temporal craniotomy, extra-dural drilling of lesser sphenoid wing, and followed by wide exposure of Sylvian fissure, STA-MCA bypass was performed. Then, through trans-Sylvian, fronto-basal, and lateral trajectory, interhemispheric fissure was dissected from the base, which enabled good exposure and clipping of high positioned AcomA aneurysm. The video can be found here: http://youtu.be/GWItnRSs3m4 .