Radiometric study on posterior inferior cerebellar aneurysms with special reference to accessibility by the lateral suboccipital approach.

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Radiometric studies were conducted in 21 cases of posterior inferior cerebellar aneurysms and 52 normal subjects to determine the variability of location of the vertebral-posterior inferior cerebellar artery complex in the posterior fossa. Accessibility using a lateral suboccipital approach was evaluated in relation to the radiometric data. Lateral suboccipital openings offered a sufficient surgical field in all cases under minimal retraction of the cerebellum and the results were satisfactory. The range of accessibility of this lateral approach was between 0 to 17 mm from the midline, 1 to 23 mm from the foramen magnum, 6 to 16 mm from the clivus and 35 to 61 mm from the posterior clinoid process. Postoperative neurological deficits were seen in patients with an aneurysm within 10 mm of the midline and at more than 13 mm from the clivus. Advantages of the lateral suboccipital approach are discussed.