title: Far-lateral approach for lower basilar artery aneurysms.
abstract: OBJECTIVE
  Aneurysms of the lower basilar artery are surgically difficult to expose and clip. Various cranial base approaches, which are associated with significant morbidity, have been used to access this region. We have used the far-lateral approach without occipital condyle drilling for clipping of lower basilar junction aneurysms to assess the exposure for adequate visualization and clipping, and to study the complications and outcome.
  
  
  METHODS
  Retrospective review of data.
  
  
  METHODS
  Between 1997 and 2001, four patients with lower basilar artery aneurysms were operated on at Louisiana State University Health Sciences Center in Shreveport. The far-lateral approach without drilling of the occipital condyle was used in each procedure.
  
  
  METHODS
  Cases of basilar artery aneurysms.
  
  
  METHODS
  Glasgow Outcome Scale (GOS) score.
  
  
  RESULTS
  All four aneurysms were clipped successfully. All patients had good outcome (GOS scores of 5 and 4). There were no instances of cerebrospinal fluid leakage or pseudomeningocele. Two patients experienced transient morbidity in the form of voice hoarseness and swallowing difficulty.
  
  
  CONCLUSIONS
  The far-lateral approach without drilling of the occipital condyle adequately exposed the lower basilar artery for successful clipping of aneurysms and was associated with minimal morbidity.
authors.affiliation: Department of Neurosurgery, Louisiana State University Health Sciences Center in Shreveport, Shreveport, Louisiana.
authors.forename: Cherukuri Ravi
authors.initials: CR
authors.lastname: Kumar
authors.forename: Prasad
authors.initials: P
authors.lastname: Vannemreddy
authors.forename: Anil
authors.initials: A
authors.lastname: Nanda