Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Acta Neurochirurgica
Published in: Acta Neurochirurgica 4/2017

01-04-2017 | How I Do it - Vascular

Transjugular tubercle-preaccessory approach for ventrocaudally located PICA aneurysm

Authors: Tetsuyoshi Horiuchi, Alhusain Nagm, Takatoshi Hasegawa, Kazuhiro Hongo.

Published in: Acta Neurochirurgica | Issue 4/2017

Login to get access

Abstract

Background

Posterior inferior cerebellar artery (PICA) aneurysms are often located in the ventral craniocervical junction. Such deep-seated aneurysms are usually treated with coil embolization. However, recurred and/or very small PICA aneurysms are hardly treated with an endovascular approach.

Method

We present a modification of the transcondylar fossa approach with intradural and extradural removal of the jugular tubercle. An adequate preaccessory surgical corridor was created with this novel technique.

Conclusion

The ventocaudal PICA aneurysm was clipped through the outside of the spinal accessory nerve without surgical manipulation of other lower cranial nerves. This approach is worthwhile to avoid dysphagia.
Appendix
Available only for authorised users
Literature
1.
Matsushima T, Matsukado K, Natori Y, Inamura T, Hitotsumatsu T, Fukui M (2001) Surgery on a saccular vertebral artery-posterior inferior cerebellar artery aneurysm via the transcondylar fossa (supracondylar transjugular tubercle) approach or the transcondylar approach: surgical results and indications for using two different lateral skull base approaches. J Neurosurg 95:268–274CrossRefPubMed
2.
Matsushima T, Natori Y, Katsuta T, Ikezaki K, Fukui M, Rhoton AL (1998) Microsurgical anatomy for lateral approaches to the foramen magnum with special reference to transcondylar fossa (supracondylar transjugular tubercle) approach. Skull Base Surg 8:119–125CrossRefPubMedPubMedCentral
3.
Wanibuchi M, Akiyama Y, Mikami T, Komatsu K, Sugino T, Suzuki K, Kanno A, Ohtaki S, Noshiro S, Mikuni N (2016) Intraoperative mapping and monitoring for rootlets of the lower cranial nerves related to vocal cord movement. Neurosurgery 78:829–834CrossRefPubMed
Metadata
Title
Transjugular tubercle-preaccessory approach for ventrocaudally located PICA aneurysm
Authors
Tetsuyoshi Horiuchi
Alhusain Nagm
Takatoshi Hasegawa
Kazuhiro Hongo.
Publication date
01-04-2017
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 4/2017
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-017-3126-z

Other articles of this Issue 4/2017

Acta Neurochirurgica 4/2017 Go to the issue

Original Article _ Brain Tumors

Supraorbital subfrontal trans-laminar endoscope-assisted approach for tumors of the posterior third ventricle

Letter to the Editor (by Invitation) - Neurosurgical Techniques

WhatsAPP in neurosurgery: the best practice is in our hands

Case Report - Functional

Trigeminal neuralgia caused by a dilated superior cerebellar artery and a draining vein of cerebellar arteriovenous malformations: a case report and review of the literature

Letter to the editor - Editorial

Letter to the Editor: WhatsAPP in neurosurgery

ACKNOWLEDGMENT TO REFEREES

Thank you list 2016

Original Article - Brain Tumors

Interobserver variability of the House-Brackmann facial nerve grading system for the analysis of a randomized multi-center phase III trial