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    Head positioning for anterior circulation aneurysms microsurgery
    (Academia Brasileira de Neurologia - ABNEURO, 2014-11-01) Chaddad Neto, Feres Eduardo Aparecido [UNIFESP]; Doria-netto, Hugo Leonardo; Campos-filho, José Maria De; Ribas, Eduardo Santamaria Carvalhal; Ribas, Guilherme Carvalhal; Oliveira, Evandro De; Universidade Federal de São Paulo (UNIFESP); Real e Benemérita Associação Portuguesa de Beneficência Instituto de Ciências Neurológicas Laboratório de Microcirurgia; Sociedade Brasileira de Neurocirurgia Departamento de Neurocirurgia Vascular; Hospital Brigadeiro Departamento de Neurocirurgia Vascular; Universidade de São Paulo (USP); Hospital Beneficência Portuguesa; Universidade Estadual de Campinas (UNICAMP)
    Objective To study the ideal patient's head positioning for the anterior circulation aneurysms microsurgery. Method We divided the study in two parts. Firstly, 10 fresh cadaveric heads were positioned and dissected in order to ideally expose the anterior circulation aneurysm sites. Afterwards, 110 patients were submitted to anterior circulation aneurysms microsurgery. During the surgery, the patient's head was positioned accordingly to the aneurysm location and the results from the cadaveric study. The effectiveness of the position was noted. Results We could determine mainly two patterns for head positioning for the anterior circulation aneurysms. Conclusion The best surgical exposure is related to specific head positions. The proper angle of microscopic view may minimize neurovascular injury and brain retraction.