Abstract
Aneurysms of the basilar artery (BA) may occur at several locations including the BA-vertebral artery junction, BA-anterior inferior cerebellar artery junction, BA-superior cerebellar artery junction, and BA tip. Upper BA aneurysm is usually considered to include BA tip aneurysm and BA-superior cerebellar artery junction aneurysm. BA aneurysm seldom manifests as neurological problems before rupture. Partially thrombosed BA aneurysm may manifest as progressive neurological deficits due to compression of the brain stem and cranial nerves caused by aneurysm growth. Unruptured BA tip aneurysm has a higher tendency to rupture compared to other types of cerebral aneurysm. Therefore, the surgical indications for unruptured BA aneurysm should consider this fact as well as the age, size, and shape of the aneurysm.
Highlights
Aneurysms of the basilar artery (BA) may occur at several locations including the BA-vertebral artery junction, BA-anterior inferior cerebellar artery junction, BA-superior cerebellar artery junction, and BA tip
The distance of the aneurysm neck from the clinoid line is important to determine the operative approach. Anterolateral approaches such as the pterional transsylvian approach and extradural temporopolar approach (ETA) are suitable for the treatment of BA aneurysms located between 15 mm above and 5 mm below the clinoid line
The anterior temporal approach is a pure intradural approach based on dissecting the superficial middle vein and anterior temporal artery from the temporal lobe
Summary
Aneurysms of the basilar artery (BA) may occur at several locations including the BA-vertebral artery junction, BA-anterior inferior cerebellar artery junction, BA-superior cerebellar artery junction, and BA tip. Upper BA aneurysm is usually considered to include BA tip aneurysm and BA-superior cerebellar artery junction aneurysm. BA aneurysm seldom manifests as neurological problems before rupture. Thrombosed BA aneurysm may manifest as progressive neurological deficits due to compression of the brain stem and cranial nerves caused by aneurysm growth. Unruptured BA tip aneurysm has a higher tendency to rupture compared to other types of cerebral aneurysm. The surgical indications for unruptured BA aneurysm should consider this fact as well as the age, size, and shape of the aneurysm
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