Abstract
BACKGROUND: The transorbital approach through the roof of the orbit can be utilized safely for the clip obliteration of ACOM aneurysms. METHOD: We demonstrate the technique and describe the limited indications for its application. The operation proceeds by strictly following the anatomic dissection of the optic nerve, A1 segment of the ACA and then dissection and clipping of the aneurysm. CONCLUSION: For the properly chosen patient and aneurysm, the transorbital approach has an excellent cosmetic outcome and can safely eliminate the aneurysm with great patient satisfaction.