Abstract
Aneurysms of the posterior cerebral circulation account for only about 15 % of all intracranial aneurysms, and surgical treatment of these aneurysms was demanding until the introduction of endovascular therapy. The surgery-related morbidity and mortality—about 10 % in the best published series—was correspondingly high. One must assume that in the average series, the surgery-related morbidity and mortality may have been about 30 % or higher. Part of the high complication rate can be linked to the relative rarity of these aneurysms, because the particular approaches and techniques require special skills and awareness of specific pitfalls. Another reason for the unsatisfactory results of microsurgical treatment, however, has certainly been the highly eloquent territory supplied by the parent arteries of these aneurysms—that is, the brainstem. Drake and Peerless from London, Ontario, acquired the world’s largest experience in the surgical treatment of aneurysms of the posterior circulation.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Drake CG, Peerless SJ, Hernesniemi JA. Surgery of vertebrobasilar aneurysms: London, Ontario, experience on 1,767 patients. New York: Springer; 1996.
Lehto H, Harati A, Niemelä M, Dashti R, Laakso A, Elsharkawy A, et al. Distal posterior inferior cerebellar artery aneurysms: clinical features and outcome of 80 patients. World Neurosurg. 2014. doi:10.1016/j.wneu.2014.06.012.
Rodriguez-Hernandez A, Rhoton Jr AL, Lawton MT. Segmental anatomy of the cerebellar arteries: a proposed nomenclature. Laboratory investigation. J Neurosurg. 2011;115:387–97.
Park SI, Kim BM, Kim DI, Shin YS, Suh SH, Chung EC, et al. Clinical and angiographic follow-up of stent-only therapy for acute intracranial vertebrobasilar dissecting aneurysms. AJNR Am J Neuroradiol. 2009;30:1351–6.
Uhl E, Schmid-Elsaesser R, Steiger HJ. Ruptured intracranial dissecting aneurysms: management considerations with a focus on surgical and endovascular techniques to preserve arterial continuity. Acta Neurochir (Wien). 2003;145:1073–83; discussion 1083–4.
Anson JA, Lawton MT, Spetzler RF. Characteristics and surgical treatment of dolichoectatic and fusiform aneurysms. J Neurosurg. 1996;84:185–93.
Westphal M, Grzyska U. Clinical significance of pedicle aneurysms on feeding vessels, especially those located in infratentorial arteriovenous malformations. J Neurosurg. 2000;92:995–1001.
D’Ambrosio AL, Kreiter KT, Bush CA, Sciacca RR, Mayer SA, Solomon RA, Connolly Jr ES. Far lateral suboccipital approach for the treatment of proximal posteroinferior cerebellar artery aneurysms: surgical results and long-term outcome. Neurosurgery. 2004;55:39–50.
Al-Khayat H, Al-Khayat H, Beshay J, Manner D, White J. Vertebral artery-posteroinferior cerebellar artery aneurysms: clinical and lower cranial nerve outcomes in 52 patients. Neurosurgery. 2005;56:2–10; discussion 11.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Steiger, HJ., Etminan, N., Hänggi, D. (2015). Aneurysms of the Vertebral Artery and Branches. In: Microsurgical Brain Aneurysms. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45679-8_9
Download citation
DOI: https://doi.org/10.1007/978-3-662-45679-8_9
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-45678-1
Online ISBN: 978-3-662-45679-8
eBook Packages: MedicineMedicine (R0)