Eyebrow keyhole approach in vascular neurosurgery

The authors review their experience in the surgery of intracranial aneurysms via an eyebrow keyhole approach. The eyebrow keyhole approach presumes a skin incision in the lateral two-thirds of the eyebrow followed by small supraorbital craniotomy (15 x 25 mm). Using this approach and an intraoperative endoscope for better visualisation of the aneurysmal neck, the authors operated on thirty-seven patients with forty intracranial aneurysms. There was no mortality, postoperative recovery was fast, and the cosmetic effect was excellent. Advantages and possibilities of this approach are discussed and results are presented. The authors recommend this approach as a minimal invasive surgery procedure in the treatment of intracranial aneurysms. When performed by experienced vascular neurosurgeons this approach is neither more difficult for the surgeon nor more dangerous for the patient than any other standard craniotomy procedure. According to the authors' present results, surgery of intracranial aneurysm via an eyebrow keyhole approach is the method of choice when performed by an experienced vascular neurosurgeon.