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Updated: Jun 2, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
Suboccipital approach for primitive trigeminal artery obliteration associated with cavernous aneurysm
Tetsuyoshi Horiuchi1, Yosuke Hara, Tetsuo Sasaki
1Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan. tetuyosi@shinshu-u.ac.jp
Objective:
A 63-year-old woman presented with diplopia resulting from abducens paralysis. Examination revealed a giant cavernous aneurysm supplied by the internal carotid artery (ICA) and primitive trigeminal artery (PTA) via the vertebrobasilar system.
Methods:
After evaluation of balloon test occlusion (BTO) at the distal side of the PTA origin, the aneurysm was treated with PTA obliteration through the suboccipital route in the lateral position followed by cervical carotid ligation with superficial temporal artery-to-middle cerebral artery anastomosis in the supine position.
Results:
The aneurysm showed marked shrinkage after the surgery.
Conclusion:
PTA obliteration through the retrosigmoid opening is a therapeutic surgical option in a patient with a cavernous aneurysm supplied by the PTA.
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