Two Cases of Superior Hypophyseal Artery Aneurysm Clipped Through Contralateral Pterional Approach.

We experienced 2 cases of small ophthalmic segment aneurysm arising from the posteromedial wall of the internal carotid artery. Based on the angiographic and operative findings, we examined the characteristics of the aneurysms in this location with reference to the origin of the superior hypophyseal artery. They were unruptured aneurysms, and were clipped successfully through the contralateral pterional approach with sacrifice of the superior hypophyseal artery because of its adhesion with the aneurysm.The postoperative course was uneventful. In this approach, we emphasize less invasiveness for clipping of the aneurysm with neither damage to the optic nerve nor the necessity of resection of the skull base such as the anterior clinoid process.We report 2 cases and review some literature that discusses the merits and demerits of the contralateral pterional approach for superior hypophyseal artery aneurysm.