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Brain Mobilization and Protection

Last Updated: September 28, 2018

Dynamic Subfrontal Retraction and Minimal Brain Mobilization for Clip Ligation of an ACoA Aneurysm via Supraorbital Craniotomy and Eye-Brow Incision

Figure 1: The use of a fixed retractor blade (left) and dynamic retraction (using bipolar forceps and suction device, right) for a subfrontal trajectory and exposure of the optic nerve is compared.  Dynamic retraction places the brain under less tension due to a more distributed retraction pressure.

Aneurysm surgery takes place around the basal cisterns, and therefore requires brain mobilization to facilitate a suitable subarachnoid trajectory for dissection of the relevant vascular territories and the aneurysm. Although fixed retractor blades are helpful in freeing the surgeon’s hands so he or she can conduct the deeper portions of the...