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Large (or Bulbous) Basilar Bifurcation Aneurysms (12.5–25 mm) 265 Patients

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Abstract

Two patients with remote bleeds 15 months and 4 years ago were classified with the 40 unruptured aneurysms (Table 4.1). In the remaining, besides the usual clinical symptoms of subarachnoid hemorrhage (SAH), 23 had CNIII palsy, one of them bilaterally. Trochlear nerve palsy was seen in four, one bilaterally, and sixth nerve palsy in seven patients, three times bilaterally.

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References

  1. Abe T, Sugishita M, Yatsuzuka S, Tashibu K, Onoue H, Suzuki T, Nakamura N: Transcallosal interforniceal approach for a posteriorly projecting high basilar bifurcation aneurysm. J Neurosurg 78: 970–973, 1993

    Article  PubMed  CAS  Google Scholar 

  2. Al-Mefty O, Anand VK: Zygomatic approach to skull base lesions. J Neurosurg 73: 668–673, 1990

    Article  PubMed  CAS  Google Scholar 

  3. Batjer HH, Samson DS: Causes of morbidity and mortality from surgery of aneurysms of the distal basilar artery. Neurosurgery 25: 904–916, 1989

    Article  PubMed  CAS  Google Scholar 

  4. Clark K: Complications of aneurysm surgery. Clin Neurosurg 23: 342–356, 1976

    PubMed  CAS  Google Scholar 

  5. de los Reyes RA, Kantrowitz AB, Boehm FH, Spatola MA: Transcallosal, transventricular approach to a basilar apex aneurysm. Neurosurgery 31: 597–602, 1992

    Article  PubMed  Google Scholar 

  6. Dolenc VV, Skrap M, Sustersic J, Skrbec M, Morina A: A transcavernous-transsellar approach to the basilar tip aneurysms. Br J Neurosurg 1: 251–259, 1987

    Article  PubMed  CAS  Google Scholar 

  7. Drake CG, Friedman AH, Peerless SJ: Failed aneurysm surgery. Reoperation in 115 cases. J Neurosurg 61: 848–856, 1984

    Article  PubMed  CAS  Google Scholar 

  8. Drake CG: Bleeding aneurysms of the basilar artery. Direct surgical management in four cases. J Neurosurg 23: 230–238, 1961

    Google Scholar 

  9. Drake CG: Further experience with surgical treatment of aneurysms of the basilar artery. J Neurosurg 29: 372–392, 1968

    Article  PubMed  CAS  Google Scholar 

  10. Drake CG: Surgical treatment of ruptured aneurysms of the basilar artery. Experience with 14 cases. J Neurosurg 23: 457–473, 1965

    Article  PubMed  CAS  Google Scholar 

  11. Drake CG: The surgical treatment of aneurysms of the basilar artery. J Neurosurg 29: 436–446, 1968

    Article  PubMed  CAS  Google Scholar 

  12. Drake CG: The surgical treatment of the vertebralbasilar aneurysms. Clin Neurosurg 16: 114–169, 1969

    PubMed  CAS  Google Scholar 

  13. Drake CG: The treatment of aneurysms of the posterior circulation. Clin Neurosurg 26: 96–144, 1979

    PubMed  CAS  Google Scholar 

  14. Ferguson GG: Physical factors in the initiation, growth and rupture of human intracranial saccular aneurysms. J Neurosurg 37: 666–677, 1972

    Article  PubMed  CAS  Google Scholar 

  15. Fox JL: Intracranial aneurysms, vol I—III. New York, Berlin, Heidelberg, Tokyo: Springer, 1983, 1463 pp

    Google Scholar 

  16. Hakuba A, Liu S, Nishimura S: The orbitozygomatic infratemporal approach: A new surgical technique. Surg Neurol 26: 271–276, 1986

    Article  PubMed  CAS  Google Scholar 

  17. Harsh GR 4th, Sekhar LN: The subtemporal, trans-cavernous, anterior transpetrosal approach to the upper brain stem and clivus. J Neurosurg 77: 709–717, 1992

    Article  PubMed  Google Scholar 

  18. Hernesniemi J, Vapalahti M, Niskanen M, Tapaninaho A, Kari A, Luukkonen M, Puranen M, Saari T, Rajpar M: One-year outcome in early aneurysm surgery: a 14 years experience. Acta Neurochir (Wien) 122: 1–10, 1993

    Article  CAS  Google Scholar 

  19. Hernesniemi JA, Vapalahti MP, Niskanen M, Kari A: Management outcome in vertebrobasilar artery aneurysms by early surgery. Neurosurgery 31: 857–862, 1992

    Article  PubMed  CAS  Google Scholar 

  20. Heros RC, Lee SH: The combined pterional/anterior temporal approach for aneurysms of the upper basilar complex. Technical article. Neurosurgery 33: 244–251, 1993

    Article  PubMed  CAS  Google Scholar 

  21. Ikeda K, Yamashita J, Hashimoto M, Futami K: Orbitozygomatic temporopolar approach for a high basilar tip aneurysm associated with a short intracranial internal carotid artery: a new surgical approach. Neurosurgery 28: 105–110, 1991

    Article  PubMed  CAS  Google Scholar 

  22. Kassel NF, Torner JC, Haley EC Jr, Jane JA, Adams HP, Kongable GL: The International Cooperative Study on the Timing of Aneurysm Surgery. Part I: Overall management results. J Neurosurg 73: 18–36, 1990

    Article  Google Scholar 

  23. Kassell NF, Torner JC, Jane JA, Haley EC Jr, Adams HP: The International Cooperative Study on the Timing of Aneurysm Surgery. Part II: Surgical results. J Neurosurg 73: 37–47, 1990

    Article  PubMed  CAS  Google Scholar 

  24. Kodama N, Sasaki T, Yamanobe K, Kikuchi Y, Kurashima Y: High position basilar top aneurysm treated via third ventricle. Neurol Surg(Tokyo) 14: 1277–1281, 1986

    CAS  Google Scholar 

  25. Lam AM, Gelb AW: Cardiovascular effects of isoflurane-induced hypotension for cerebral aneurysm surgery. Anesth Analg 64: 742–748, 1983

    Google Scholar 

  26. Marinkovic SV, Gibo H: The surgical anatomy of the perforating branches of the basilar artery. Neurosurgery 33: 80–87, 1993

    Article  PubMed  CAS  Google Scholar 

  27. Matsuno H, Rhoton AL Jr, Peace D: Microsurgical anatomy of the posterior fossa cisterns. Neurosurgery 23: 58–80, 1988

    Article  PubMed  CAS  Google Scholar 

  28. Mizoi K, Takahashi A, Yoshimoto T, Fujiwara S, Koshu K: Combined endovascular and neurosurgical approach for paraclinoid internal carotid artery aneurysms. Neurosurgery 33: 986–992, 1993

    Article  PubMed  CAS  Google Scholar 

  29. Mizoi K, Yoshimoto T, Takahashi A, Ogawa A: Direct clipping of basilar trunk aneurysms usink temporary balloon occlusion. J Neurosurg 80: 230–236, 1994

    Article  PubMed  CAS  Google Scholar 

  30. Neil-Dwyer G, Sharr M, Haskell R, Currie D, Hosseini M: Zygomaticotemporal approach to the basis cranii and basilar artery. Neurosurgery 23: 2022, 1988

    Google Scholar 

  31. Norrgârd O, Ängqvist KA, Fodstad H, Forssell A, Lindberg M: Coexistence of abdominal aortic aneurysms and intracranial aneurysms. Acta Neurochir (Wien) 87: 34–39, 1987

    Article  Google Scholar 

  32. Pedrozo A, Dujovny M, Ausman JI, Diaz FG, Artero JC, Berman SK, Mirchandani HG, Umansky F: Micro-vascular anatomy of the posterior fossa. J Neurosurg 64: 484–493, 1986

    Article  Google Scholar 

  33. Peerless SJ, Drake CG: Management of aneurysms of posterior circulation.In: Youmans JR (ed) Neurological surgery, vol 3, 3rd ed. Philadelphia: Saunders, 1990, pp 1764–1806

    Google Scholar 

  34. Peerless SJ, Hernesniemi JA, Gutman FB, Drake CG: Early surgery for ruptured posterior circulation aneurysms. J Neurosurg 80: 643–649, 1994

    Article  PubMed  CAS  Google Scholar 

  35. Peerless SJ: Pre-and postoperative management of cerebral aneurysms. Clin Neurosurg 26: 209–231, 1979

    PubMed  CAS  Google Scholar 

  36. Pool JL, Potts DG: Aneurysms and arteriovenous anomalies of the brain. Diagnosis and treatment. New York: Harper and Row, 1965

    Google Scholar 

  37. Rice BJ, Peerless SJ, Drake CG: Surgical treatment of unruptured aneurysms of the posterior circulation. J Neurosurg 73: 165–173, 1990

    Article  PubMed  CAS  Google Scholar 

  38. Saeki N, Rhoton AL Jr: Microsurgical anatomy of the upper basilar artery and the posterior circle of Willis. J Neurosurg 46: 563–578, 1977

    Article  PubMed  CAS  Google Scholar 

  39. Samson DS, Hodosh RM, Clark WK: Microsurgical evaluation of the pterional approach to aneurysms of the distal basilar circulation. Neurosurgery 3: 135141, 1978

    Google Scholar 

  40. Sano K: Temporopolar approach to aneurysms of the basilar artery at and around the distal bifurcation: Technical note. Neurol Res 2: 361–367, 1980

    PubMed  CAS  Google Scholar 

  41. Shiokawa Y, Saito I, Aoki N, Mizutani H: Zygomatic temporopolar approach for basilar artery aneurysms. Neurosurgery 24: 385–391, 1989

    Article  Google Scholar 

  42. Solomon RA, Stein BM: Surgical approaches to aneurysms of the vertebral and basilar arteries. Neurosurgery 23: 203–208, 1988

    Article  PubMed  CAS  Google Scholar 

  43. Sugita K, Kobayashi S, Shintani A, Mutsuga N: Micro-neurosurgery for aneurysms of the basilar artery. J Neurosurg 51: 615–620, 1979

    Article  PubMed  CAS  Google Scholar 

  44. Suzuki J, Kwak R, Okudaira Y: The safe time limit of temporary clamping of cerebral arteries in the direct surgical treatment of intracranial aneurysm under moderate hypothermia. In: Suzuki J (ed) Cerebral aneurysms: experiences with 1000 directly operated cases. Tokyo: Tokyo Press, 1979, pp 325–329

    Google Scholar 

  45. Toyota BD, Ferguson GG: Basilar artery dissection: An early postoperative complication of aneurysm clipping. J Neurosurg 81: 139–142, 1994

    Article  PubMed  CAS  Google Scholar 

  46. Yasargil MG, Antic J, Lagica R, Jain KK, Hodosh RM, Smith RD: Microneurosurgical pterional approach to aneurysms of the basilar bifurcation. Surg Neurol 6: 83–91, 1976

    PubMed  CAS  Google Scholar 

  47. Yasargil MG: Vertebrobasilar aneurysms. In: Micro-neurosurgery in 4 volumes, vol II. Stuttgart, New York: Thieme, 1986, pp 232–295

    Google Scholar 

  48. Yoshimoto T, Uchida K, Kaneko U, Kayama T, Suzuki J: An analysis and follow-up results of 1000 intracranial saccular aneurysms with definitive surgical treatment. J Neurosurg 50: 152–157, 1979

    Article  PubMed  CAS  Google Scholar 

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Drake, C.G., Peerless, S.J., Hernesniemi, J.A. (1996). Large (or Bulbous) Basilar Bifurcation Aneurysms (12.5–25 mm) 265 Patients. In: Surgery of Vertebrobasilar Aneurysms. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9409-6_4

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  • DOI: https://doi.org/10.1007/978-3-7091-9409-6_4

  • Publisher Name: Springer, Vienna

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