Objective  To explore the efficacy and safety of lateral supraorbital approach (LSO) in treatment of acute ruptured middle cerebral artery (MCA) aneurysm.

  Methods  The clinical data of 48 patients with MCA aneurysm were retrospectively analyzed. The Hunt-Hess gradeⅠ to Ⅲ and the modified CT Fisher grade Ⅱ to Ⅲ were selected as selection criteria for these patients. The LSO was used and MCA aneurysm clipping was performed. Patients were followed up for one year, and the outcome of surgery was evaluated by Glasgow Outcome Scale (GOS). The follow-up period was one year, and the effect of the operation was evaluated by the Glasgow Outcome Scale (GOS).

  Results  Aneurysms were successfully clipped in all 48 patients. GOS results showed that 40 cases were grade Ⅴ (recovery of normal working) and 8 cases were grade Ⅳ (mild disability).

  Conclusion  LSO microsurgery for acute ruptured MCA aneurysms is effective, but its efficacy and safety need to be further confirmed by larger sample size and long-term follow-up.