Transpetrosal Combined Supratentorial and Infratentorial Approach for Midline Vertebro-Basilar Aneurysms

Hashi, Kazuo; Nin, Kiyoshi; Shimotake, Katsumi

doi:10.1007/978-3-662-08801-2_50

Cited by 14 publications

(6 citation statements)

References 4 publications

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“…Several authors have contributed to the development of this approach and have previously described it in detail. [1,12,14,29] In brief, a retromastoid skin incision is extended approximately 5 cm above the external auditory meatus and curved gently forward, ending anterior to the tragus. A partial mastoidectomy skeletonizing the labyrinth, posterior fossa dura, sigmoid sinus, and superior petrosal sinus is combined with an L-shaped craniotomy around the ear to complete the bone exposure.…”

Section: Combined Petrosal Approachmentioning

confidence: 99%

“…[6,8,21,22] Both Drake [8] and Malis and colleagues [6,21] identified and reported the reasons for a combined supra-infratentorial approach to aneurysms in this region. Hashi and colleagues [14] eloquently described such a strategy in the late 1970s. Samii, et al, [24] further refined the technique for use in managing petroclival tumors.…”

Section: Combined Petrosal Approachmentioning

confidence: 99%

“…Variations of this approach have been described previously, especially for use in cranial base neoplasms. [1,12,14,[19][20][21][22]29] Accessible structures include the BA trunk, the SCA, AICA, and in many circumstances the vertebrobasilar junction.…”

Section: Combined Petrosal Approachmentioning

confidence: 99%

See 2 more Smart Citations

Cranial base approaches to posterior circulation aneurysms

Day¹,

Fukushima²,

Giannotta³

1997

FOC

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Aneurysms arising from the posterior circulation, especially when they are large and complex, continue to present a technical challenge. The development of cranial base strategies and principles has added to surgical management options. The authors used one of four cranial base approaches for the treatment of 30 patients with large and/or complex aneurysms arising from the vertebrobasilar circulation. These approaches included the extradural temporopolar, combined petrosal, retrolabyrinthine-transsigmoid, and the extreme-lateral inferior transtubercular exposure. The indications, technique, and results of each approach in this series are discussed, and a management paradigm is suggested for such aneurysms.

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Section: Combined Petrosal Approachmentioning

confidence: 99%

Section: Combined Petrosal Approachmentioning

confidence: 99%

See 1 more Smart Citation

Cranial base approaches to posterior circulation aneurysms

Day¹,

Fukushima²,

Giannotta³

1997

FOC

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“…There have been various reports [3,5,6,10,11,16] dealing with approaches to aneurysms in this limited surgical field. Although hypothermic circulatory arrest and interventional surgery have been attempted, if the aneurysm is large and reaches a giant size, both the rate of complications and morbidity will rise, thus making this a challenging task for neurosurgeons.…”

Section: Introductionmentioning

confidence: 99%

Deep hypothermia cardiopulmonary bypass and direct surgery of two large aneurysms at the vertebro-basilar junction

et al. 1996

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This paper highlights two interesting cases of radial clipping of large aneurysms at the vertebro-basilar junction accompanied by a vascular anomaly, consisting of fenestration of the split basilar artery at its origin. Description of the inner and outer surface of the aneurysm were obtained pre-operatively, from analysis by 3D CT and 3D CT endoscopy of the form of the neck, parent vessels of the vertebral arteries on both sides, basilar artery and split basilar artery, as well as other details of branching. The neck exhibited a broad base in both cases. The height of the neck extended to the internal acoustic meatus, and it was possible to expose the circumference of the aneurysmal neck, peripheral basilar artery and both vertebral arteries proximally with an anterior, transpetrosal approach. Based on the size of the aneurysm and the site being the anterior surface of the brain stem, clipping (consisting of interruption of the occluded portion and reconstruction of the parent vessels) was performed. In the first case it was achieved protecting the brain by hypothermia and barbiturates under deep hypothermia with extracorporal circulation, and in the second case, a state of circulatory arrest was used. This paper documents the report of two cases along with other cases treated so far.

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“…[13,17] Combined Petrosal Approach Several authors have contributed to the development of this approach and have previously described it in detail. [1,12,14,29] In brief, a retromastoid skin incision is extended approximately 5 cm above the external auditory meatus and curved gently forward, ending anterior to the tragus. A partial mastoidectomy skeletonizing the labyrinth, posterior fossa dura, sigmoid sinus, and superior petrosal sinus is combined with an L-shaped craniotomy around the ear to complete the bone exposure.…”

mentioning

confidence: 99%