Imaging above depicts an angiogram which captured an anterior communicated artery aneurysm. Neurosurgeons will have various preferences as to whether one should surgically clip or coil the aneurysm. Such treatment options depend on the features of the lesion such as the neck “size“ of the aneurysm. Most neurosurgeons, if chosen craniotomy, will go with a Pterional approach to which is really a lateral sub-frontal skull based exposure (one needs to flatten the sphenoid wing). Then, splitting of the Sylvian Fissure is needed along with a possible gyrus rectus removal (very small portion can be removed which may or may not be necessary).