Middle cerebral artery (MCA)
aneurysms are associated with one of the most favorable approaches for microsurgical treatment; however,
aneurysm geometrics can pose challenges during
clip application. The surgeon must be mindful of the
clip configuration options available during the planning of ideal
clip occlusion for irregular or multilobulated
aneurysm domes. This patient had an incidental multilobulated MCA bifurcation
aneurysm and underwent an orbitozygomatic approach for microsurgical treatment. Proximal and distal control of the
aneurysm were achieved, and complete
clip occlusion was achieved following the placement of a single permanent
clip. Flow within the parent vessel was well preserved, and complete
aneurysm occlusion was achieved. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.