How I do it - focused Sylvian approach for clipping of middle cerebral artery aneurysms

Milad Neyazi; Rajiv Kumar Khajuria; Sajjad Muhammad

doi:10.1007/s00701-025-06423-9

How I do it - focused Sylvian approach for clipping of middle cerebral artery aneurysms

Acta Neurochir (Wien). 2025 Jan 10;167(1):9. doi: 10.1007/s00701-025-06423-9.

Authors

Milad Neyazi¹, Rajiv Kumar Khajuria¹, Sajjad Muhammad²

Affiliations

¹ Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
² Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany. sajjad.muhammad@med.uni-duesseldorf.de.

Abstract

Background: The Focused Sylvian Approach (FSA) is a refined, minimally invasive technique for clipping small to medium-sized middle cerebral artery (MCA) aneurysms, prioritizing safety and aesthetics.

Method: The craniotomy remains confined to the superior temporal line, with the incision concealed within the temporal muscle. The Sylvian fissure is carefully dissected to preserve venous structures.

Conclusion: FSA achieves optimal vascular control with superior cosmetic outcomes while maintaining adequate exposure for safe aneurysm clipping.

Keywords: Intracranial aneurysm; Middle cerebral artery; Minimal invasive surgery; Neurovascular surgery techniques; Pterional craniotomy.

MeSH terms

Craniotomy* / methods
Humans
Intracranial Aneurysm* / diagnostic imaging
Intracranial Aneurysm* / surgery
Middle Cerebral Artery* / surgery
Minimally Invasive Surgical Procedures / methods
Neurosurgical Procedures* / methods
Surgical Instruments