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Basilar bifurcation aneurysms associated with persistent primitive hypoglossal artery
K Sakai1, Y Tanaka, K Tokushige
1Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
Neurosurgical Review
|March 6, 1999
Summary
Ruptured basilar aneurysms linked to a persistent primitive hypoglossal artery were successfully treated. Surgical clipping via an ipsilateral approach provided safe proximal control for these challenging low-positioned aneurysms.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Cerebrovascular Anatomy
Background:
- Ruptured basilar bifurcation aneurysms are rare and complex cerebrovascular lesions.
- A persistent primitive hypoglossal artery is an uncommon anatomical variant that can influence surgical approaches.
- Associated vascular anomalies, such as hypoplastic vertebral and posterior communicating arteries, can complicate aneurysm management.
Observation:
- Two cases of ruptured basilar bifurcation aneurysm were identified.
- Both aneurysms were associated with a persistent primitive hypoglossal artery.
- Angiography demonstrated low-positioned aneurysms with bilateral hypoplastic or aplastic vertebral and posterior communicating arteries.
Findings:
- Successful surgical clipping of both basilar bifurcation aneurysms was achieved.
- A subtemporal transtentorial approach through an ipsilateral craniotomy was employed.
- Ipsilateral craniotomy and cervical carotid artery exposure facilitated safe proximal control of the basilar artery.
Implications:
- This surgical strategy offers a viable option for managing complex basilar bifurcation aneurysms in the presence of a persistent primitive hypoglossal artery.
- Understanding the anatomical variations is crucial for planning safe and effective neurosurgical interventions.
- The described approach highlights the importance of proximal control in complex aneurysm surgery.