title: Suboccipital approach for primitive trigeminal artery obliteration associated with cavernous aneurysm.
abstract: OBJECTIVE
  A 63-year-old woman presented with diplopia resulting from abducens paralysis. Examination revealed a giant cavernous aneurysm supplied by the internal carotid artery (ICA) and primitive trigeminal artery (PTA) via the vertebrobasilar system.
  
  
  METHODS
  After evaluation of balloon test occlusion (BTO) at the distal side of the PTA origin, the aneurysm was treated with PTA obliteration through the suboccipital route in the lateral position followed by cervical carotid ligation with superficial temporal artery-to-middle cerebral artery anastomosis in the supine position.
  
  
  RESULTS
  The aneurysm showed marked shrinkage after the surgery.
  
  
  CONCLUSIONS
  PTA obliteration through the retrosigmoid opening is a therapeutic surgical option in a patient with a cavernous aneurysm supplied by the PTA.
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan. tetuyosi@shinshu-u.ac.jp
authors.forename: Tetsuyoshi
authors.initials: T
authors.lastname: Horiuchi
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Hara
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Sasaki
authors.forename: Hisashi
authors.initials: H
authors.lastname: Nagashima
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hongo
mesh_terms: D001488:Basilar Artery / Q000002:abnormalities / Q000601:surgery*; D020215:Carotid Artery, Internal, Dissection / Q000473:pathology / Q000601:surgery*; D020226:Cavernous Sinus Thrombosis / Q000473:pathology / Q000601:surgery*; D002548:Cerebral Revascularization / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D056888:Patient Positioning / Q000379:methods; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000379:methods*