2019 Volume 47 Issue 2 Pages 134-139
In many cases with basilar top aneurysm, we recommend the anterior temporal approach, that combines the beneficial features of the pterional and subtemporal approach. However, in cases of aneurysms that are higher than 1 cm from the interclinoid line, large in size, or show posterior projection, the orbitozygomatic approach is more suitable. Each approach has been used properly depending on the height, size, or projection of the aneurysm. Not only the aneurysmal situation but also the surrounding vascular structure is clinically important as the retrocarotid space is restricted by the severely calcified or laterally deviated internal carotid artery and/or middle cerebral artery. Therefore, we should preoperatively pay attention to the anatomical vascular structures around the basilar top aneurysm even if the aneurysm itself can be easily approached.
