A case of basilar artery-superior cerebellar artery aneurysm successfully treated with the modified Dolenc approach

• Published in: Medical Journal of Shimane Prefectural Central Hospital Vol. 48; no. 1; pp. 67 - 71
• Main Authors: Mishima, Hiroto, Ikawa, Fusao, Hidaka, Toshikazu, Ochiai, Junichiro, Oku, Shinichiro, Horie, Nobutaka
• Format: Journal Article
• Language: Japanese
• Published: Shimane Prefectural Central Hospital 10.03.2024
• Subjects: Modified Dolenc approach, basilar artery aneurysm, clippig
• ISSN: 0289-5455; 2435-0710
• DOI: 10.34345/spch.48.1_67

Posterior cerebral circulation aneurysms are difficult to reach surgically because of their deep location in the brain. In recent years, endovascular coil embolization has been the first choice in many centers. However, it is assumed that surgical treatment options may be necessary for various reasons. We report a case in which a basilar artery-superior cerebellar artery aneurysm was successfully treated by clipping. The patient, a woman in her 70s, underwent clipping of an incidental aneurysm of the basilar artery-superior cerebellar artery. Intraoperative findings indicated that the anterior temporal approach was difficult, so a modified Dolenc approach was used, and neck clipping was possible. Various approaches have been developed to obtain a good surgical field for distal basilar artery aneurysms. Because of the risk of nerve damage associated with the dissection of the intrinsic dura mater during epidural manipulation, we report on our efforts to minimize the need for this manipulation and to ensure sufficient working space.