The small "surgical aneurysm" at the basilar apex.
OBJECTIVE
Because the risks are reduced, larger basilar apex aneurysms are usually treated endovascularly instead of with surgery. However, small basilar apex aneurysms are more common and an unfavorable shape may prevent definitive endovascular treatment. The goal of this study was to reevaluate the outcome of traditional surgery for small unruptured basilar apex aneurysms as an alternative to the currently more accepted endovascular treatment.


METHODS
The authors reviewed clinical data obtained in 21 patients who underwent surgery between 2000 and 2007 for unruptured basilar apex aneurysms < 7 mm.


RESULTS
The median age of the 21 patients was 52 years (range 29-74 years). All patients experienced a good outcome. Two patients harbored a small residual aneurysm (> 95% occlusion). Eight patients (38%) suffered a temporary third nerve paresis, which resolved in all cases.


CONCLUSIONS
Surgical clip ligation remains an excellent treatment for small basilar apex aneurysms. The treatment is definitive and in experienced hands is associated with a low risk.
Hauck
Erik Friedrich
EF
Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas 75390, USA. erik.hauck@utsouthwestern.edu
White
Jonathan Ari
JA
Samson
Duke
D
D000328:Adult; D000368:Aged; D003399:Craniotomy; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000601:surgery*; D008026:Ligation; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000209:etiology