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Acta Neurochirurgica
Published in: Acta Neurochirurgica 8/2019

01-08-2019 | Craniotomy | How I Do it - Vascular Neurosurgery - Aneurysm

Clipping of a PICA aneurysm located on the contralateral side of its parent vertebral artery in front of the brainstem: how I do it

Authors: Michel W. Bojanowski, Pascale Lavoie, Elsa Magro

Published in: Acta Neurochirurgica | Issue 8/2019

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Abstract

Background

Vertebro-PICA aneurysms may be challenging because of their relationship with the brainstem and the lower cranial nerves, especially when the vertebral artery is tortuous and the aneurysm is located in front of the brainstem, contralaterally to the parent vertebral artery. We describe the surgical technique for safe approach.

Method

Cadaveric dissection performed by the authors, provided comprehensive understanding of relevant anatomy. Intraoperative photos and videos show clipping of the aneurysm using a combined midline and far-lateral suboccipital craniotomy with a para-condylar extension. The literature reviews potential complications.

Conclusion

This combined approach allows safe clipping of such PICA aneurysms.
Appendix
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Literature
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Metadata
Title
Clipping of a PICA aneurysm located on the contralateral side of its parent vertebral artery in front of the brainstem: how I do it
Authors
Michel W. Bojanowski
Pascale Lavoie
Elsa Magro
Publication date
01-08-2019
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 8/2019
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-019-03967-5

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