Surgical management of vertebrobasilar aneurysms

This paper reports a retrospective analysis of 50 patients who had 55 posterior circulation aneurysms treated surgically. Twenty-four patients presented with subarachnoid haemorrhage. Thirty-three of the lesions involved the basilar artery, predominantly at its bifurcation. There were 13 giant aneurysms in the series, 3 false aneurysms, 1 mycotic aneurysm and 3 associated with arteriovenous malformations. Forty-nine aneurysms (89%) were able to be treated surgically and 38 (69%) of these were directly clipped. Neurological assessment at discharge indicated that 38 patients (76%) had a good outcome. Moderate disability occurred in 7 patients (14%). Four patients (8%) were left severely disabled or vegetative. There was a single death in the series (2%).