Exposure of the vertebrobasilar artery junction with traction of the dentate ligament for the treatment of large vertebral artery aneurysms: technical note.
A technique for exposing the vertebrobasilar junction with traction of the dentate ligament is described for treatment of large vertebral artery (VA) aneurysms via the far lateral suboccipital approach with partial condylar resection. The most rostral attachment of the dentate ligament is divided above the site where the VA pierces the dura mater. A traction suture is placed into the dentate ligament and gently retracted using mosquito forceps. As a result, the medulla oblongata is lifted dorsally and slightly rotated by the divided and retracted dentate ligament, allowing an approach from a more superior or inferior direction. The present technique is useful for the treatment of large thrombosed VA aneurysms.
Department of Neurosurgery, Iwate Medical University School of Medicine, Morioka, Iwate, Japan. hkashi@iwate-med.ac.jp
Hiroshi
H
Kashimura
Kuniaki
K
Ogasawara
Yoshitaka
Y
Kubo
Shunsuke
S
Kakino
Kenji
K
Yoshida
Masayuki
M
Sasoh
Hajime
H
Takahashi
Kenji
K
Suzuki
Akira
A
Ogawa
D000328:Adult; D018891:Dentate Gyrus / Q000601:surgery; D004210:Dissection / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D014143:Traction; D014711:Vertebral Artery