Acta Neurochirurgica

, 153:2103 | Cite as

Exclusively intradural exposure and clip reconstruction in complex paraclinoid aneurysms

  • Volker SeifertEmail author
  • Erdem Güresir
  • Hartmut Vatter
How I Do It



The management of complex paraclinoid aneurysms is still challenging. In this article we describe our approach to paraclinoid aneurysms, which has evolved over several years, using an exclusively intradural approach.


All procedures are done under continuous electrophysiological monitoring. A standard pterional approach is used to access the paraclinoid region exclusively intraduraly. After optic nerve unroofing and tailored clinoidectomy, the aneurysm neck is visualized and clipped using the tandem clipping technique and suction decompression if necessary. Aneurysm occlusion is verified using intraoperative ICG angiography and postoperative 3D DSA.


The exclusively intradural approach to complex paraclinoid aneurysms with tailored clinoidectomy offers an excellent surgical corridor for the treatment of these challenging lesions.


Intracranial aneurysm Subarachnoid hemorrhage Clipping Paraclinoid aneurysm Coiling 


Conflicts of interest


Supplementary material

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Volker Seifert
    • 1
    Email author
  • Erdem Güresir
    • 1
  • Hartmut Vatter
    • 1
  1. 1.Department of NeurosurgeryJohann Wolfgang Goethe-UniversityFrankfurt am MainGermany

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