title: Clinical presentation and treatment of aneurysms associated with basilar artery fenestration.
abstract: Aneurysms associated with a fenestrated basilar artery are rare, and treatment strategies have yet to be established. A direct surgical approach to the basilar artery is challenging because the surrounding anatomy is complex. We retrospectively compared the clinical features and treatment outcomes of eight patients (seven female, one male) with aneurysms associated with a fenestrated basilar artery after clipping or coil embolisation and reviewed the literature. Of the eight aneurysms, four were ruptured; seven aneurysms were located at the proximal part of the basilar artery and one aneurysm was located at the middle of the basilar artery. Six aneurysms were surgically treated. Four aneurysms were embolised with Guglielmi detachable coils, two aneurysms were clipped via the transcondylar or temporopolar approach, and two aneurysms were not treated. All six surgically treated patients had good outcomes. We found that both coil embolisation and direct clipping to treat aneurysms associated with a fenestrated basilar artery have advantages and disadvantages. To obtain favourable outcomes, the selected treatment modality must consider the patient's age and clinical condition, the aneurysm size and shape, the direction of the dome, the relationship with perforators, and the neurosurgeon's expertise.
authors.affiliation: Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima 890-8544, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tokimura
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Makiuchi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Nagayama
authors.forename: Koji
authors.initials: K
authors.lastname: Takasaki
authors.forename: Tetsuzo
authors.initials: T
authors.lastname: Tomosugi
authors.forename: Kazuho
authors.initials: K
authors.lastname: Hirahara
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yamahata
authors.forename: Francia
authors.initials: F
authors.lastname: Campos
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Nishizawa
authors.forename: Kazunori
authors.initials: K
authors.lastname: Arita
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000601:surgery; D020771:Anterior Cerebral Artery / Q000473:pathology; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000150:complications / Q000473:pathology; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000628:therapy*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome