Abstract
Basilar tip aneurysms account for 5% - 8% of all intracranial aneurysms. They are known to rupture more frequently than aneurysms in other locations. Surgical clipping of basilar apex aneurysms however challenging; remains the treatment of choice in Ivory Coast due in part, to multiple technical barriers. A 60-year-old right-handed patient presented to our Neurosurgical Unit in February 2nd 2013 after a sudden onset of altered consciousness. Neurological examination revealed both an upper motor neuron and meningeal syndromes with a Glasgow Coma Scale of 12. Brain NECT scan and a subsequent brain CT angiography showed a subarachnoid haemorrhage and a 3.8 mm (height) × 5.2 mm (width) basilar tip aneurysm respectively. Surgical clipping of the aneurysm was indicated but due to multiple technical barriers, surgery was delayed and the patient underwent surgery after the critical vasospasm period. The patient developed a hospital acquired pneumonia after surgery and was successfully treated with antibiotics. Since her discharge, she has been asymptomatic. We sought to report this case of a basilar apex aneurysm successfully occluded with non-ferromagnetic SUGITA clips and to share our experience of clipping these lesions through the frontotemporal approach. The patient was informed that non identifying information from the case would be submitted for publication, and she provided consent.
Highlights
IntroductionBasilar tip aneurysms account for 5% - 8% of all intracranial aneurysms and 50% of vertebro-basilar system aneurysms are located in the basilar apex [1] [2]
We sought to report this case of a basilar apex aneurysm successfully occluded with non-ferromagnetic SUGITA clips and to share our experience of clipping these lesions through the frontotemporal approach
Basilar tip aneurysms account for 5% - 8% of all intracranial aneurysms and 50% of vertebro-basilar system aneurysms are located in the basilar apex [1] [2]
Summary
Basilar tip aneurysms account for 5% - 8% of all intracranial aneurysms and 50% of vertebro-basilar system aneurysms are located in the basilar apex [1] [2] They carry a higher risk of rupture than aneurysms in other locations and constitute a major surgical challenge, due mainly to difficulties controlling proximal feeding. General principles governing surgical treatment of intracranial aneurysms namely proximal and distal control of feeding arteries, microdissection, meticulous saving of thalamoperforating arteries and minimal injury to complex nerve structures are difficult to achieve in the setting of posterior circulation aneurysms [6]. We sought to report this case of a basilar apex aneurysm successfully occluded with non-ferromagnetic SUGITA clips and to share our experience of clipping these lesions through the frontotemporal approach. We will detail our clinical case and technical nuances of our surgical approach, as well as present our clinical experience with it
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