The transcondylar approach, consisting of lateral suboccipital craniotomy along with removal of the lateral margin of the foramen magnum, the posteromedial one third of the occipital condyle and the arch of the atlas, allows good access to the anterior margin of the foramen magnum and the lower clival areas (the anterior aspect of the medulla oblongata) from below, without retraction of the cerebellum or the brain stem.
This approach was successfully utilized for direct clipping of aneurysms of the vertebral artery and the vertebrobasilar junction.
