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Updated: Jul 3, 2026
18:50
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Moyamoya disease associated with basilar tip aneurysm
A K Bhattacharjee1, N Tamaki, H Minami
1Department of Neurosurgery, Kobe University, School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Summary
Delayed surgery for ruptured basilar tip aneurysms in moyamoya disease patients yields better outcomes. Careful surgical techniques and patient selection are crucial for successful treatment of these complex cases.
Area of Science:
- Neurosurgery
- Vascular Neurology
Background:
- Ruptured basilar tip aneurysms in moyamoya disease are challenging to treat surgically.
- Previous surgical interventions have shown limited patient recovery.
Purpose of the Study:
- To review surgical outcomes for ruptured basilar tip aneurysms in patients with moyamoya disease.
- To identify factors influencing successful surgical intervention.
Main Methods:
- Retrospective review of six cases, including the authors' own.
- Analysis of surgical timing, techniques, and patient outcomes.
Main Results:
- Delayed surgery (after 4 weeks) correlated with impressive patient recovery.
- Acute-stage surgery resulted in two deaths and one excellent recovery among three patients.
- Key factors for success include delayed operation, bypass consideration, collateral preservation, and neuroanesthetic techniques.
Conclusions:
- Delayed surgical intervention is preferable for ruptured basilar tip aneurysms in moyamoya disease.
- Meticulous surgical technique, including preservation of collaterals and appropriate neuroanesthesia, is essential.
- Extracranial-intracranial bypass may benefit selected patients.
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