The role of the surgical technique in incidence of postoperative epileptic seizures in unruptured intracranial aneurysm clipping

[...]if on one hand the necessity of dialysis is a not modifiable risk factor, iatrogenic brain injuries are basically related to the surgeons' experience and to their technical skills. In our recent experience of the last 10 years, we noticed that the improvement of the expertise due to the formation of an ultra-specialized neurovascular team along with a progressive technical refinement characterized by a miniaturization in the approaches, the complete abolition of the brain retractors, and the tailored open of the cisternal spaces, in particular of the sylvian fissure for the treatment of the middle cerebral artery aneurysms, have led to a substantial reduction in the incidence of epileptic seizures. Overall, Recently, we retrospective reviewed our series of clipping of unruptured aneurysms of the anterior circulation of the past 12 years, and we appreciated a reduction of the seizures incidence of seizures from more than 3% to