title: Surgical treatment of a basilar perforator aneurysm not accessible to endovascular treatment.
abstract: Aneurysms originating from perforatoring branches of the midbasilar artery are extremely rare. Rupture of such an aneurysm resulted in a subarachnoid hemorrhage with a prepontine clot in a 44 year old male who presented with an acute confusional state. After coil embolization had failed, the partially thrombosed aneurysm was wrapped and coagulated via a combined supra-/infratentorial subtemporal presigmoid approach in prone position. The postoperative course was complicated by a tension pneumatocephalus and liquorrhea. Additional aneurysms of the anterior communicating artery and right middle cerebral artery were clipped several months later. The patient recovered well, and except for slight gait ataxia no other deficit remained.
authors.affiliation: Klinik für Neurochirurgie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany. w.hamel@uke.uni-hamburg.de
authors.forename: W
authors.initials: W
authors.lastname: Hamel
authors.forename: U
authors.initials: U
authors.lastname: Grzyska
authors.forename: M
authors.initials: M
authors.lastname: Westphal
authors.forename: U
authors.initials: U
authors.lastname: Kehler
mesh_terms: D000328:Adult; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002941:Circle of Willis / Q000473:pathology / Q000601:surgery; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D020767:Intracranial Thrombosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D020768:Middle Cerebral Artery / Q000473:pathology / Q000601:surgery; D019635:Neurosurgical Procedures / Q000379:methods* / Q000639:trends; D011149:Pons / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D012086:Reoperation; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013525:Surgical Instruments; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods* / Q000639:trends