Introduction: A lot of controversies are there in treating Acom aneurysm surgery. Proximal control, timing of surgery, Sylvian fissure dissection, approach and patient selection are few of those. Avoiding major disasters such as perforator injury is mandatory, proximal control of both A1 in intraoperative rupture is worth living. The technique of arachnoid dissection to prevent injury to AcoA complex and brain retraction facilitates surgery.  In this series, complication avoidance of 16 cases has been discussed. In order to avoid a major disaster such as perforator injury, proximal control of both A1 in intraoperative rupture is deserving of life. The arachnoid dissection technique to prevent injury to the AcoA complex and brain retraction facilitates the surgery. In this series, Complication avoidance of 16 cases was discussed.

Material and Method: A retrospective study of 16 cases of which 9 were male and 7 were female was observed. Prevention of complications has been studied in Acom aneurysm surgery.

Results: Of 16 patients — 2 died 1 developed 3rd nerve paralysis which was recovered after 3 months, 1 developed hydrocephalus.

Conclusion: The complexity of the location means that complications in Acom neurysm surgery must be avoided. The learning curve to avoid complications is a step in the right direction. Collection of larger series will contribute further to society.

Keywords: Acom aneurysm surgery, Proximal control, AcoA complex.

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Dr Md Moshiur Rahman

Assistant Professor (current charge), Neurosurgery Department, HFRCMC, Dhaka, Bangladesh