The aim of treatment of giant aneurysms is to overcome the mass effect and to prevent hemorrhage and thromboembolic complications. Larger sight is required for leaving the giant aneurysm out of circulation and excision of aneurysm mass. Removal of thrombotic material may be required after transient clip for this reason.

Although pterional approach is widely used for anterior communicating aneurysms, cranioorbital, interhemispheric, transorbital approaches are also recommended. Even though bifrontal craniotomy, orbitozygomatic and interhemispheric approaches are generally performed, combination of different approaches may be necessary for giant aneurysms. Right frontotemporal and left unilateral semifrontal craniotomy as Sekhar defined were performed in this case. We believe that this approach is suitable for giant anterior communicating aneurysms since it provides transsylvian, subfrontal, interhemispheric approach that creates working area. Anahtar Kelimeler : Anterior aneurysms, Aneurysms, Giant aneurysms, Anterior communicating aneurysms, ACoA, Craniotomy