The supraorbital keyhole approach effectively exposes the frontal lobe base, anterior clinoid process, canalis opticus, olfactory sulcus, olfactory tract, optic nerve, optic chiasm, oculomotor nerve, anterior communicating artery, anterior cerebral artery A1 segment, pituitary stalk, diaphragma sellae, dorsum sellae, posterior clinoid process, basilar artery apex, posterior cerebral artery P1 segment, superior cerebellar artery proximal, front upper pontine and interpeduncular cistern, anteromedial temporal lobe, internal carotid, middle cerebral artery (M1, M2 segment, and part of M3 segment), anterior choroidal artery, posterior communicating artery; and contralateral carotid artery medial surface, anterior cerebral artery A1 and A2 proximal, middle cerebral artery M1 and M2 proximal.
And, it can expose ipsilateral tractus opticus, internal carotid artery, posterior communicating artery, anterior choroidal artery, thalamus arteriae perforantes, posterior cerebral artery, and pituitary stalk.
Four were on the left side of the anterior circulation (Figures 1 and 2): one at the bifurcation of the left internal carotid artery (ICA) and anterior choroidal artery (AN1), 2 adjacent ones in the horizontal part of the left middle cerebral artery (MCA) (AN2 and AN3), and one at the bifurcation of the left MCA (AN4).
A 61-year-old male presented with 2 unruptured aneurysms in the right anterior circulation (Table 1, Figures 1 and 4): one at the bifurcation of the left ICA and anterior choroidal artery (AN7) and one at the bifurcation of the MCA (AN8).
Digital subtraction cerebral angiography (DSA) showed multiple vascular lesions, including an obvious saccular aneurysm on the left anterior choroidal artery.
Digital subtraction cerebral angiography, performed an hour later, revealed a saccular aneurysm on the left anterior choroidal artery (AChA) and infundibular morphology of both posterior communicating arteries (PCoAs) [Figure 2].
8] The main branches of the internal carotid artery include: the ophthalmic artery, anterior choroidal artery, the posterior communicating artery, the anterior cerebral artery and the middle cerebral artery.
The anterior choroidal artery (Table 1) is responsible for supplying blood to deep structures of the brain including the globus pallidus (basal ganglia), lateral geniculate body (thalamus), posterior limb of the internal capsule and medial temporal lobe.