Basilar Aneurysm: Subtemporal Approach
Last Updated: September 28, 2018
Although the transsylvian approach with its half-and-half modifications can reach most basilar bifurcation aneurysms, some low-lying aneurysms will not be amenable to this approach. This is particularly true if the aneurysm neck resides up to 5 to 10 mm below the dorsum sella as seen on a sagittal view of the computed tomography (CT) angiogram.
In addition, I do not favor the pterional route for posterior-projecting aneurysms because the vital thalamoperforators are buried behind the aneurysm and often not easily viewable through the subfrontal operative trajectory.
The subtemporal approach addresse...