Abstract
We describe a technique of a trans-sylvian STA-SCA anastomosis for the vertebrobasilar insufficiency. The procedure utilizes the combined pterional/anterior temporal approach and tentorial edge resection, and anastomosis is performed at the anterior pontmesencephalic segment of the SCA just lateral to the oculomotor nerve. This can provide a wider and shallower microsurgical space than the standard STA-SCA anastomosis via subtemporal approach; however, validation of this procedure is mandatory for it to become an alternative to the routine STA-SCA anastomosis.
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