{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:01:47Z","timestamp":1780131707801,"version":"3.54.0"},"reference-count":74,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The objective was to compare the clinical and surgical outcomes of patients with bilateral intracranial aneurysms treated via a single craniotomy against those treated with bilateral craniotomies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 50 patients who underwent microsurgical clipping of bilateral aneurysms\u2014specifically involving the middle cerebral artery (MCA) or internal carotid artery (ICA)\u2014between 2008 and 2019. Clinical, demographic, and morphological variables were recorded. Clinical outcomes were compared between patients who were treated through a single craniotomy (n = 32) against those who underwent bilateral craniotomies (n = 18). Aneurysm occlusion and rebleeding rates were compared between aneurysms on the basis of whether clipping was performed via an ipsilateral or contralateral approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Thirty-seven patients (74%) presented with subarachnoid hemorrhage. A total of 125 aneurysms were included: 84 (67.2%) were clipped ipsilaterally and 41 (32.8%) contralaterally. No significant differences were observed in clinical presentation, duration of surgery, complication rates, length of hospitalization, mortality, or functional outcomes at 6-month follow-up between the two groups. The median (IQR) postoperative hospital stay was 8 (13) days in the single craniotomy group and 14 (12) days in the bilateral craniotomy group, though this difference was not statistically significant (p = 0.054). The intercarotid distance was significantly shorter in the single craniotomy group (p = 0.007). Operative bleeding was greater in the single craniotomy group (p &lt; 0.001). Aneurysms clipped ipsilaterally exhibited significantly greater dome height (p = 0.013) and were more complex (p = 0.003). No significant differences were found in aneurysm occlusion, rebleeding, or reintervention rates between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In patients with bilateral ICA or MCA aneurysms, clipping via a single craniotomy provides clinical outcomes comparable to bilateral craniotomies. Contralateral clipping does not adversely affect occlusion or complication rates, supporting the safety and feasibility of a unilateral surgical approach for safe microsurgical clipping in selected cases of bilateral aneurysms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.9.focus25747","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T13:25:03Z","timestamp":1764595503000},"page":"E5","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and surgical outcomes of bilateral intracranial aneurysms clipped through a single craniotomy: a retrospective comparative cohort study"],"prefix":"10.3171","volume":"59","author":[{"given":"Juan Luis","family":"G\u00f3mez-Amador","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, National Institute of Neurology and Neurosurgery Manuel Velasco Su\u00e1rez, Mexico City, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliezer","family":"Villanueva-Castro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Nathal-Vera","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Neurology and Neurosurgery Manuel Velasco Su\u00e1rez, Mexico City, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Jos\u00e9","family":"M\u00e9ndez-Gallardo","sequence":"additional","affiliation":[{"name":"Division of Interventional Neurology, NewCity Hospital, Tijuana, Baja California, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Wong-Achi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Neurology and Neurosurgery Manuel Velasco Su\u00e1rez, Mexico City, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis A.","family":"Rodr\u00edguez-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Neurology and Neurosurgery Manuel Velasco Su\u00e1rez, Mexico City, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo","family":"Villalobos-D\u00edaz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Neurology and Neurosurgery Manuel Velasco Su\u00e1rez, Mexico City, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Terrazas-Aguirre","sequence":"additional","affiliation":[{"name":"Centro M\u00e9dico ABC, Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Beristain","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Neurology and Neurosurgery Manuel Velasco Su\u00e1rez, Mexico City, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerardo Y.","family":"Guinto-Nishimura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Neurology and Neurosurgery Manuel Velasco Su\u00e1rez, Mexico City, Mexico;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"J Craniofac Surg","first-page":"e518","article-title":"Surgical treatment strategy and perioperative analysis of patients with intracranial mirror aneurysms","volume":"30","author":"Zhou H","year":"2019","unstructured":"Zhou H, Cheng J, Liu H, Lu D, Feng Y. 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