Trans-lateral ventricular approach for surgical treatment of a high located basilar apex aneurysm: report of a rare presentation of the disease and surgical technique

Abstract

Surgical management of basilar apex aneurysms is considered among the most technically challenging procedures and high located basilar apex makes the procedure more challenging. Pterional trans-sylvian (with or without orbitozygomatic extension) and subtemporal are the most commonly used approaches, however, it is sometimes difficult or impossible to access a high-positioned aneurysm of basilar bifurcation without excessive retraction of brain and neurovascular structures. We are reporting a 65-year-old woman presented with chronic hydrocephalus secondary to a high-located basilar apex aneurysm surgically clipped through trans-frontal trans-ventricular trans-choroidal approach. We described anatomical details for selecting this approach and surgical steps during the procedure.

Keywords:

• Basilar tip aneurysm
• basilar apex aneurysm
• trans-ventricular approach

Disclosure statement

No potential conflict of interest was reported by the author(s).