Surgery for anterior communicating artery aneurysms: Lessons learnt

Background: Anterior communicating artery (ACoA) aneurysms are one of the most common cerebral aneurysms encountered by neurovascular surgeons. They are surgically complex and sensitive and the scope for dialogue and exchange towards development are never over rated. Aims and objectives: The authors seek to discuss and emphasize on key lessons learnt from the observations from ACoA aneurysms treated by micro-vascular clipping. Materials and Methods: Hospital based retrospective observational study of 237 cases of ACoA aneurysms admitted to the study hospital and treated by micro-vascular clipping. Conclusion: The lessons learnt are broadly under the headings: exposure, intracranial pressure, gyrus rectus resection, vascular anatomy, perforator preservation, temporary clipping, damage control, lamina terminalis fenestration, team play, cognitive and morbidity assessment, and timing of surgery.