{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T23:10:01Z","timestamp":1756509001477,"version":"3.44.0"},"reference-count":41,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Multiple minicraniotomies (Mct) have been proposed as alternatives to standard pterional craniotomy (Pct) for intracranial aneurysm treatment. These approaches offer limited surgical corridors and distinct working angles, posing challenges in addressing all aneurysm types with one method. We suggest a tailored Mct technique, comprising three minimally invasive approaches targeting anterior circulation aneurysm sites (middle cerebral artery, internal carotid artery, anterior communicating artery).<\/jats:p><jats:p>We conducted a retrospective, case\u2013control study at a single center comparing Pct and Mct outcomes for ruptured and unruptured aneurysms. Parameters evaluated included conversion rates to Pct or decompressive hemicraniectomy (DHC), intraoperative rupture (IOR), surgical complications, complete aneurysm exclusion, 6-month modified Rankin Scale (mRS) scores, and aesthetic outcomes using a visual analog scale. A total of 146 patients were included, with 103 in the Mct group and 43 in the Pct group, comparable in mean age, sex, and aneurysm topography. Hunt\u2013Hess scores and Fisher grades were lower in the Mct group initially.<\/jats:p><jats:p>No cases required conversion from Mct to Pct or DHC. No significant differences were observed in IOR, surgical complications, and aneurysm exclusion rates between groups. The Mct group demonstrated better 6-month mRS scores and aesthetic outcomes.<\/jats:p><jats:p>Our study indicates that tailored Mct is as safe and effective as standard Pct for intracranial aneurysms, with significant cosmetic benefits. Thus, tailored Mct can be considered a valuable alternative not only to Pct but also to other minimally invasive surgical methods for these aneurysms.<\/jats:p>","DOI":"10.1055\/a-2399-0008","type":"journal-article","created":{"date-parts":[[2024,8,21]],"date-time":"2024-08-21T19:04:40Z","timestamp":1724267080000},"page":"602-610","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Analysis of Tailored Minicraniotomy versus Standard Pterional Craniotomy in the Treatment of Anterior Circulation Aneurysms: A Single-Center Case\u2013Control Observational Study"],"prefix":"10.1055","volume":"86","author":[{"given":"Giosu\u00e8","family":"Dipellegrini","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Azienda Ospedaliero Universitaria di Sassari, Sassari, ita\u00f2y, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Boccaletti","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Azienda Ospedaliero Universitaria di Sassari, Sassari, ita\u00f2y, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Mingozzi","sequence":"additional","affiliation":[{"name":"Department of Oncology, Medical Oncology Unit, University Hospital of Parma, parma, italy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Sanna","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Experimental Sciences, G&O Clinic, University of Sassari, Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenico","family":"Policicchio","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Azienda Ospedaliero Universitaria \u201cRenato Dulbecco\u201d di Catanzaro, Sassari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,10,14]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.nec.2022.05.005","article-title":"Minimally invasive and outpatient aneurysm surgery: new concepts","volume":"33","author":"S Karadimas","year":"2022","journal-title":"Neurosurg Clin N Am"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/j.wneu.2013.02.072","article-title":"The pterional and suprabrow approaches for aneurysm surgery: a systematic review of intraoperative rupture rates in 9488 aneurysms","volume":"80","author":"V S Madhugiri","year":"2013","journal-title":"World Neurosurg"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"e800","DOI":"10.1016\/j.wneu.2018.07.057","article-title":"Experience using the pterional keyhole approach for the treatment of ruptured intracranial aneurysms of the anterior circulation","volume":"118","author":"Y Tang","year":"2018","journal-title":"World Neurosurg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.wneu.2017.09.058","article-title":"Minipterional and supraorbital keyhole craniotomies for ruptured anterior circulation aneurysms: experience at single center","volume":"109","author":"H Tra","year":"2018","journal-title":"World Neurosurg"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1080\/01616412.2018.1531202","article-title":"Keyhole approaches for surgical treatment of intracranial aneurysms: a short review","volume":"41","author":"J Rychen","year":"2019","journal-title":"Neurol Res"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/3-211-27911-3_4","article-title":"Lateral supraorbital approach as an alternative to the classical pterional approach","volume":"94","author":"J Hernesniemi","year":"2005","journal-title":"Acta Neurochir Suppl (Wien)"},{"issue":"S 02","key":"ref7","first-page":"200","article-title":"The minipterional craniotomy for anterior circulation aneurysms: initial experience with 72 patients","volume":"10","author":"J M Caplan","year":"2014","journal-title":"Neurosurgery"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"E324","DOI":"10.1227\/NEU.0000000000000456","article-title":"Clinical and surgical experience with the minipterional craniotomy","volume":"75","author":"E G Figueiredo","year":"2014","journal-title":"Neurosurgery"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/978-3-319-39546-3_15","article-title":"Minipterional craniotomy for treatment of unruptured middle cerebral artery aneurysms. 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