Combined transsylvian-subtemporal exposure of cerebral aneurysms involving the basilar apex

T. A. Kopitnik, H. H. Batjer, D. S. Samson

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

The surgical repair of cerebral aneurysms involving the apex of the basilar artery continues to undergo refinement and evolution. The inherent difficulty in accessing the basilar apex as well as the complexities of the microanatomy render this area a notoriously hazardous and technically challenging region in which to perform microsurgical clipping of cerebral aneurysms. Several operative approaches have been described and are constantly undergoing a state of evolution in the hopes of optimizing the exposure of the distal basilar artery and minimizing the inherent risks of surgery. The consistent decline in operative morbidity has paralleled improved understanding of the microvascular anatomy, both in this region and along the various corridors of approach. No single operative approach is universally superior, considering the wide variability of individual patient anatomy and vascular configurations. Each approach has strengths, weaknesses, and potential complications that must be considered in the thought process of planning an operative attack on a basilar apex aneurysm. Intimate familiarity with the microvasculature and the microsurgical anatomy of the region is an imperative prerequisite for the application of any surgical approach to this region. This paper outlines a detailed review of the microsurgical anatomy that is pertinent to microsurgery of aneurysms in this region, and describes an approach referred to as the combined transsylvian-subtemporal approach. We have found this operative approach particularly useful in aneurysm surgery of the basilar apex but do not mean to imply that this single approach is suitable for all surgeons or all patients. This paper is designed to discuss an approach and microanatomic understanding that we find useful in the surgical treatment of aneurysms involving the basilar apex.

Original languageEnglish (US)
Pages (from-to)534-540
Number of pages7
JournalMicrosurgery
Volume15
Issue number8
DOIs
StatePublished - 1994

Fingerprint

Intracranial Aneurysm
Aneurysm
Anatomy
Basilar Artery
Microsurgery
Microvessels
Blood Vessels
Morbidity
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Combined transsylvian-subtemporal exposure of cerebral aneurysms involving the basilar apex. / Kopitnik, T. A.; Batjer, H. H.; Samson, D. S.

In: Microsurgery, Vol. 15, No. 8, 1994, p. 534-540.

Research output: Contribution to journalArticle

@article{048398ed66fe4de9be65414f9ebadf7e,
title = "Combined transsylvian-subtemporal exposure of cerebral aneurysms involving the basilar apex",
abstract = "The surgical repair of cerebral aneurysms involving the apex of the basilar artery continues to undergo refinement and evolution. The inherent difficulty in accessing the basilar apex as well as the complexities of the microanatomy render this area a notoriously hazardous and technically challenging region in which to perform microsurgical clipping of cerebral aneurysms. Several operative approaches have been described and are constantly undergoing a state of evolution in the hopes of optimizing the exposure of the distal basilar artery and minimizing the inherent risks of surgery. The consistent decline in operative morbidity has paralleled improved understanding of the microvascular anatomy, both in this region and along the various corridors of approach. No single operative approach is universally superior, considering the wide variability of individual patient anatomy and vascular configurations. Each approach has strengths, weaknesses, and potential complications that must be considered in the thought process of planning an operative attack on a basilar apex aneurysm. Intimate familiarity with the microvasculature and the microsurgical anatomy of the region is an imperative prerequisite for the application of any surgical approach to this region. This paper outlines a detailed review of the microsurgical anatomy that is pertinent to microsurgery of aneurysms in this region, and describes an approach referred to as the combined transsylvian-subtemporal approach. We have found this operative approach particularly useful in aneurysm surgery of the basilar apex but do not mean to imply that this single approach is suitable for all surgeons or all patients. This paper is designed to discuss an approach and microanatomic understanding that we find useful in the surgical treatment of aneurysms involving the basilar apex.",
author = "Kopitnik, {T. A.} and Batjer, {H. H.} and Samson, {D. S.}",
year = "1994",
doi = "10.1002/micr.1920150804",
language = "English (US)",
volume = "15",
pages = "534--540",
journal = "Microsurgery",
issn = "0738-1085",
publisher = "Wiley-Liss Inc.",
number = "8",

}

TY - JOUR

T1 - Combined transsylvian-subtemporal exposure of cerebral aneurysms involving the basilar apex

AU - Kopitnik, T. A.

AU - Batjer, H. H.

AU - Samson, D. S.

PY - 1994

Y1 - 1994

N2 - The surgical repair of cerebral aneurysms involving the apex of the basilar artery continues to undergo refinement and evolution. The inherent difficulty in accessing the basilar apex as well as the complexities of the microanatomy render this area a notoriously hazardous and technically challenging region in which to perform microsurgical clipping of cerebral aneurysms. Several operative approaches have been described and are constantly undergoing a state of evolution in the hopes of optimizing the exposure of the distal basilar artery and minimizing the inherent risks of surgery. The consistent decline in operative morbidity has paralleled improved understanding of the microvascular anatomy, both in this region and along the various corridors of approach. No single operative approach is universally superior, considering the wide variability of individual patient anatomy and vascular configurations. Each approach has strengths, weaknesses, and potential complications that must be considered in the thought process of planning an operative attack on a basilar apex aneurysm. Intimate familiarity with the microvasculature and the microsurgical anatomy of the region is an imperative prerequisite for the application of any surgical approach to this region. This paper outlines a detailed review of the microsurgical anatomy that is pertinent to microsurgery of aneurysms in this region, and describes an approach referred to as the combined transsylvian-subtemporal approach. We have found this operative approach particularly useful in aneurysm surgery of the basilar apex but do not mean to imply that this single approach is suitable for all surgeons or all patients. This paper is designed to discuss an approach and microanatomic understanding that we find useful in the surgical treatment of aneurysms involving the basilar apex.

AB - The surgical repair of cerebral aneurysms involving the apex of the basilar artery continues to undergo refinement and evolution. The inherent difficulty in accessing the basilar apex as well as the complexities of the microanatomy render this area a notoriously hazardous and technically challenging region in which to perform microsurgical clipping of cerebral aneurysms. Several operative approaches have been described and are constantly undergoing a state of evolution in the hopes of optimizing the exposure of the distal basilar artery and minimizing the inherent risks of surgery. The consistent decline in operative morbidity has paralleled improved understanding of the microvascular anatomy, both in this region and along the various corridors of approach. No single operative approach is universally superior, considering the wide variability of individual patient anatomy and vascular configurations. Each approach has strengths, weaknesses, and potential complications that must be considered in the thought process of planning an operative attack on a basilar apex aneurysm. Intimate familiarity with the microvasculature and the microsurgical anatomy of the region is an imperative prerequisite for the application of any surgical approach to this region. This paper outlines a detailed review of the microsurgical anatomy that is pertinent to microsurgery of aneurysms in this region, and describes an approach referred to as the combined transsylvian-subtemporal approach. We have found this operative approach particularly useful in aneurysm surgery of the basilar apex but do not mean to imply that this single approach is suitable for all surgeons or all patients. This paper is designed to discuss an approach and microanatomic understanding that we find useful in the surgical treatment of aneurysms involving the basilar apex.

UR - http://www.scopus.com/inward/record.url?scp=0027992014&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027992014&partnerID=8YFLogxK

U2 - 10.1002/micr.1920150804

DO - 10.1002/micr.1920150804

M3 - Article

C2 - 7830534

AN - SCOPUS:0027992014

VL - 15

SP - 534

EP - 540

JO - Microsurgery

JF - Microsurgery

SN - 0738-1085

IS - 8

ER -