Subtemporal approach for distal basilar occlusion for giant aneurysm. Nuances and advantages of the subtemporal approach

Giuseppe Lanzino, Delia Cannizzaro, Stefano Lorenzo Villa

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

We described the subtemporal approach, which was used for distal basilar artery occlusion in a patient with a symptomaticgiant unclippable aneurysm. We discuss issues related to positioning and lumbar drainage. We illustrate the basicsteps: identification of the tentorial notch; sharp opening of the arachnoid behind the third nerve; placement of a fixedmechanical retractor to "hold" the brain; identification of the third nerve and mobilization from arachnoid attachments;identification of the course and insertion of the fourth nerve; division and retraction of the tentorial edge to enhanceexposure; preparation of the "perforator-free zone" and final clip application followed by ICG fluorescein angiography.We show some of the areas exposed with this approach.

Original languageEnglish (US)
Article numberV5
JournalNeurosurgical Focus
Volume38
DOIs
StatePublished - 2015

Keywords

  • Basilar artery
  • Intracranial aneurysm
  • Subtemporal approach
  • Tentorial edge
  • Unclippable aneurysm

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology
  • Medicine(all)

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