Background: In this era of minimally invasive treatment, it is important to make operative scars as inconspicuous as possible, and there is a great deal of room for improvement in daily practice. Zigzag incision with coronal incision has been described mainly in the field of plastic surgery, and its applicability for skin incision in general neurosurgery has not been reported. Methods: Zigzag incision with 1.5-layer method was applied to 14 patients with unruptured cerebral aneurysm between April 2011 and August 2012. A questionnaire survey was administered among patients with unruptured aneurysm using SF-36v2 since April 2010. The results were compared between patients with zigzag incision and a previous cohort with traditional incision. Results: There were no cases of complications associated with the operative wound. In the questionnaire survey, all parameters tended to be better in the patients with zigzag incision, and role social component score (RCS) was significantly higher in the zigzag group than in the traditional incision group (P =0.0436). Conclusion: Zigzag incision using the 1.5-layer method with frontotemporal craniotomy seems to represent an improvement over the conventional curvilinear incision with regard to cosmetic outcome and RCS.
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