title: Simultaneous posterior communicating artery aneurysm clipping and selective amygdalohippocampectomy via direct lateral access through the mesial temporal lobe to the basal cisterns.
abstract: We report a 23-year-old man with intractable epilepsy and an incidental posterior communicating artery aneurysm who was treated simultaneously for both pathologies. He was counseled regarding the potential to treat both pathologies with one procedure. He elected to undergo a simultaneous approach. The patient was doing well at his 5-month follow-up examination with no residual seizures or neurologic deficits. We conclude that access to aneurysms within the basal cisterns is viable with transchoroidal approaches through the temporal horn of the lateral ventricle. Anterior extension through portions of the amygdala further increases access. In our patient, selective amygdalohippocampectomy and posterior communicating artery aneurysm clipping were performed during the same surgical setting/approach. This directly lateral corridor allowed our young patient with an incidental aneurysm to undergo a less invasive combined operation rather than two separate procedures.
authors: Division of Neurological Surgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, 350 West Thomas Road, Phoenix, Arizona 85013, USA.
authors: Adib A
authors: AA
authors: Abla
authors: Kris A
authors: KA
authors: Smith
authors: Peter
authors: P
authors: Nakaji
mesh_terms: D000679:Amygdala / Q000473:pathology / Q000601:surgery*; D004827:Epilepsy / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006624:Hippocampus / Q000473:pathology / Q000601:surgery*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D013702:Temporal Lobe / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult