title: Surgical clipping of a basilar perforator artery aneurysm: a case of avoiding perforator sacrifice.
abstract: BACKGROUND
  Aneurysms arising from basilar perforator arteries are very rare. A primary goal of surgery is always preservation of perforator flow. However, in most surgically managed cases in the literature, sacrifice of the perforator was reported. It is important for the literature to demonstrate that patency of the perforator is an achievable goal.
  
  
  OBJECTIVE
  To present the second reported case of perforator flow preservation in the surgical management of basilar perforator artery aneurysms.
  
  
  METHODS
  A 45-year-old woman presented with World Federation of Neurologic Surgeons grade 1 subarachnoid hemorrhage. Digital subtraction angiography ultimately revealed a 2-mm aneurysm of the basilar artery arising from a perforator after an initially negative angiogram. Clipping was performed with perforator patency confirmed on direct inspection and intraoperative angiography. The patient's postoperative course was uneventful, and postoperative magnetic resonance imaging (MRI) showed no evidence of brainstem stroke.
  
  
  CONCLUSIONS
  Although patency of the perforator is a rather obvious goal of cerebrovascular surgery, the current literature does not reflect an ability to do so in the case of basilar perforator aneurysms. We present only the second reported case of maintenance of perforator flow after clipping of a basilar perforator artery aneurysm.
authors.affiliation: Department of Neurosurgery, University of South Florida, Tampa, Florida, United States.
authors.forename: Sananthan
authors.initials: S
authors.lastname: Sivakanthan
authors.affiliation: Department of Neurosurgery, University of South Florida, Tampa, Florida, United States.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Carlson
authors.affiliation: Department of Neurosurgery, University of South Florida, Tampa, Florida, United States.
authors.forename: Harry
authors.initials: H
authors.lastname: van Loveren
authors.affiliation: Department of Neurosurgery, University of South Florida, Tampa, Florida, United States.
authors.forename: Siviero
authors.initials: S
authors.lastname: Agazzi
mesh_terms: D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000601:surgery*