Abstract
A case of basilar-superior cerebellar junction (BA-SCA) aneurysm associated with Moyamoya disease is reported. The patient was 60-year-old woman stricken by right intracerebral and intraventricular hemorrhage. Consequently, she complained of left hemiplegia and right oculomotor palsy. Operation was performed with orbitozygomatic temporopolar approach (OZT).
In the operation for aneurysm associated with Moyamoya disease in the end part of the basilar artery, it is necessary to keep the following in mind: 1) Difficulty in clipping, because of the interference by complicatedly intertwined abnormal vessels. 2) The necessity of employing an approaching method that protects the surrounding brain, which is essentially very weak against ischemia and compression.
In the approach used in our present case (OZT), it was possible to see, from below, all the blood vessels in the anterior half of the circle of Willis, including the“moyamoya”vessels. It was almost unnecessary to apply the spatula to the frontal lobe, and besides, it minimized contacts with abnormal vessels. At the same time, it makes it possible to have a wider operative space, thereby making the clipping easier.
We report on the usefulness of orbitozygomatic temporopolar approach for BA-SCA aneurysm associated with Moyamoya disease, in comparison with the other approaching methods (subtemporal and pterional).
