BACKGROUND: @entity439 located between the 2 middle cerebral artery (MCA) bifurcations may be approachable through a single unilateral approach. OBJECTIVE: To identify anatomic parameters based on imaging that would favor a contralateral approach. METHODS: From January 1998 to December 2013, we retrospectively identified 173 @entity1 with bilateral @entity438 . Fifty-one @entity1 had @entity438 . A total of 38 @entity1 underwent a single craniotomy with a contralateral microsurgical approach (group 1 or contralateral group) and 13 @entity1 underwent bilateral craniotomies (group 2 or bilateral group). For both groups, we analyzed @entity439 characteristics, morphology, size, projections, and distance to the contralateral corridor, as well as surgical time, outcome, and @entity260 . RESULTS: All @entity439 approached contralaterally were unruptured and without wall calcifications. Of the contralaterally approached @entity439 , 97% were smaller than 14 mm. The median length of the contralateral A1 was 13.2 mm (range: 6-19.8 mm) and the median length of the contralateral M1 was 14.2 mm (range: 4.6-21 mm). The contralateral group had a good postoperative outcome (modified Rankin Scale 0-3) in 80% of ruptured cases and 86% of unruptured cases. The median surgical time was 120 minutes (range: 75-255 minutes), 43% shorter than the bilateral group. CONCLUSION: The contralateral approach for @entity438 in selected @entity1 is feasible in experienced hands, with acceptable morbidity and mortality. The contralateral approach requires a meticulous preoperative analysis of the characteristics of the @entity439 to be clipped and of the anatomic constraints of the microsurgical operative corridor. ABBREVIATIONS: A1, anterior cerebral artery proximal segmentbMCA, bilateral middle cerebral arteryCTA, computed tomographic angiographyHH, Hunt-Hess scaleIA, @entity932 , internal carotid arteryICAbif, internal carotid artery bifurcationMCA, middle cerebral arteryM1, middle cerebral artery proximal segmentmRS, modified Rankin ScaleSAH, @entity510 .

Contralateral Approach to XXXX : Comparative Study, Angiographic Analysis, and Surgical Results.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity932 :: ('MESH:D020300', 'Disease') :: ['intracranial aneurysmsICA'] @entity510 :: ('MESH:D013345', 'Disease') :: ['subarachnoid hemorrhage'] @entity260 :: ('MESH:D011183', 'Disease') :: ['postoperative complications'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysms', 'Bilateral aneurysms', 'aneurysm'] @entity438 :: ('MESH:D002532', 'Disease') :: ['bilateral MCA aneurysms', 'intracranial aneurysms']
@entity438 :: (MESH:D002532,Disease) :: ['Bilateral Middle Cerebral Artery Aneurysms']
