Surgical intervention for a giant aneurysm of the vertebral artery--case report

A radical operation in an elderly man with a giant aneurysm of the vertebral artery was successfully performed. The aneurysm in the posterior fossa caused symptoms such as a disturbance of the lower cranial nerves, as well as pyramidal and cerebellar signs. An aneurysmectomy was performed for decompression of the brain stem and cranial nerves. An extended lateral suboccipital approach was chosen which made it possible to remove the rim of the foramen magnum and reach the condylar fossa. This approach also made access to the vertebro-basilar junction possible for trapping. After resection of the aneurysm and thrombectomy (endaneurysmal microendarterectomy), the aneurysmal neck as well as its clipping was closed, and consequently its parent artery. The procedure is described in this report.