Key result
Transpetrosal-anterosigmoidal clipping successfully occludes ruptured vertebrobasilar union aneurysm with full ambulation at 3 weeks.
Why the study?
Clipping a vertebrobasilar union aneurysm is one of the most difficult surgical procedures because it is deep and surrounded by important structures including the brain stem, lower cranial nerves, and cerebellum.
Case Report (n=1)
No
Answers are grounded in this paper and cite their sources.
Should not change practice; leaves open feasibility of transpetrosal-anterosigmoidal clipping in ruptured vertebrobasilar aneurysms.
Clipping a vertebrobasilar union aneurysm is one of the most difficult surgical procedures, because it is deep and surrounded by many important structures, such as the brain stem, lower cranial nerves and cerebellum.We have experienced a successful clipping of the aneurysm at this portion through a transpetrosal-anterosigmoidal approach. We report it and discuss the approaches to aneurysm at this portion.This approach has many advantages: 1) A small scalp incision. 2) Drilling the posterior pyramis is easy, because the procedure is superficial. 3) Both side of parent artery of the aneurysm can be kept. 4) Little damage to the brain stem, cerebellum and cranial nerves by retractions. 5) Short cut to the aneurysm. 6) A subtemporal approach can be easily combined if it should be required.
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英紀 et al. (1989) conducted a case report in Ruptured vertebrobasilar union saccular aneurysm (n=1). Transpetrosal-anterosigmoidal approach for aneurysm neck clipping was evaluated on Successful aneurysm neck clipping and postoperative neurological recovery. Transpetrosal-anterosigmoidal neck clipping achieved complete occlusion of a ruptured vertebrobasilar union aneurysm in 1 patient, allowing independent ambulation at 3 weeks without complications.
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