Format

Send to

Choose Destination
Acta Neurochir (Wien). 2019 Aug;161(8):1529-1533. doi: 10.1007/s00701-019-03967-5. Epub 2019 Jun 28.

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

Author information

1
Division of Neurosurgery, Centre Hospitalier de l'Université de Montréal, 1051 Sanguinet street, Montreal, QC, H2X 3E4, Canada. michel.bojanowski.chum@ssss.gouv.qc.ca.
2
Division of Neurosurgery, CHU de Quebec, Hôpital l'Enfant Jésus, Quebec, Canada.
3
Department of Neurosurgery, University Hospital of Brest, Brest, France.
4
LaTIM, INSERM, UMR 1011, Paris, France.

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.

KEYWORDS:

Contralateral approach; Far-lateral approach; PICA aneurysms; Para-condylar extension

PMID:
31250177
DOI:
10.1007/s00701-019-03967-5

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center