Keywords: basilar tip aneurysm, subtemporal approach, posterior communicating artery
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Copyright © 2008 Kakino et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. Subtemporal approach to basilar tip aneurysm with division of posterior communicating artery: Technical note Correspondence: Shunsuke Kakino Department of Neurosurgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan Tel +81 19 651 5111 Fax +81 19 625 8799 Email
skakino/at/iwate-med.ac.jp | ||||
Abstract The subtemporal approach with division of the posterior communicating artery (PcomA) is described for treating aneurysms of the basilar tip. When the ipsilateral posterior cerebral artery (PCA) interferes with visibility and manipulation around the aneurysm neck and the artery is tethered by the PcomA and not mobilized, the PcomA can be divided near the junction with the PCA. The procedure permits PCA mobilization and exposes the neck of the aneurysm. We applied this procedure to a patient with a ruptured aneurysm of the basilar tip. The postoperative course was uneventful except for transient left oculomotor nerve palsy. Postoperative cerebral angiography and magnetic resonance imaging confirmed the respective disappearance of the aneurysm and no new ischemic lesions. The subtemporal approach allows safer and easier division of the PcomA near the junction to the PCA compared with the pterional approach, and the present procedure is more suitable for the subtemporal approach. Keywords: basilar tip aneurysm, subtemporal approach, posterior communicating artery | ||||