How I do it - focused Sylvian approach for clipping of middle cerebral artery aneurysms.

Background: The Focused Sylvian Approach (FSA) is a refined, minimally invasive technique for clipping small to medium-sized middle cerebral artery (MCA) aneurysms, prioritizing safety and aesthetics. Method: The craniotomy remains confined to the superior temporal line, with the incision concealed within the temporal muscle. The Sylvian fissure is carefully dissected to preserve venous structures.

Conclusion: FSA achieves optimal vascular control with superior cosmetic outcomes while maintaining adequate exposure for safe aneurysm clipping.