Prognosis Analysis Of Middle Cerebral Bifurcation Artery Aneurysm By Different Craniotomy Approaches

ObjectiveCraniotomy aneurysm clipping is the main surgical method for middle cerebral bifurcation artery aneurysms,pterional approach and lateral supraorbital approach are two common approaches.There is no agreement on which surgical approach has a better prognosis for patients at home and abroad.Based on this,this study discussed the therapeutic effect of different surgical approaches by comparing and analyzing the prognosis of patients.MethodsWe retrospectively collected patients admitted to the neurosurgery department of our hospital from January 1,2015 to September 30,2019.Patients included in the study were divided into PA surgery group and LSA surgery group.We compared the prognosis through the operation time,postoperative complications,postoperative hospitalization time,mRS score at discharge and the basic information of included patient we collected.And then the efficacy of different approaches was analyzed.ResultsThere were 192 patients included in the study in all,including 166 patients with rupture type,109 patients with PA surgery,and 57 patients with LSA surgery.There were 26 unruptured patients,17 with PA and 9 with LSA.It showed that,in ruptured aneurysms,compared with the lateral supraorbital approach group,operative time of the pterional approach group was longer(p<0.001),with more postoperative complications(p=0.025),longer postoperative hospital stay(p=0.004),and higher mRS at discharge(p<0.001).In unruptured aneurysms,compared with the lateral supraorbital approach group,the mRS of the patients of the pterional approach group was higher at discharge(p=0.042).There was no statistical significance in the data of operation time,postoperative complications and postoperative hospitalization time(p>0.05).ConclusionBased on this study,we could draw the following conclusions that:for ruptured middle cerebral artery bifurcation aneurysms with no rupture or hunt-hess less than grade Ⅲ,the postoperative clinical effect of patients with the lateral supraorbital approach is better than that of patients with the pterional approach.