“…This approach has been used for lesions located very high with respect to posterior biclinoidal line [Jennett, 1975;Kasdon, 1979;Ikeda, 1991;Bowles, 1995;Sindou, 2001] because both zygomatic arch and orbital roof translocation together allow the complete observation of the implant base and the possibility of manipulating these aneurysms from different directions (Figures 11 and 12). performed during the endoscope-assisted microsurgical treatment of a basilar tip aneurysm through a right FTOZ approach; it is clear that the endoscope allows a better panoramic vision of the aneurysm (An) with minimal retraction of the internal carotid artery (ICA) and of the short posterior communicating artery (PCoA) from which a critical perforator (Perf), not visible in pure microscopic vision, enters the mesencephalon; the parental basilar artery (BA) with its distal branches, superior cerebellar artery (SCA) and posterior cerebral artery (PCA), are also better controlled by the endoscope; the scope also allows a better control of the distal portion of the clip (arrows).…”