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Updated: Apr 19, 2026
11:58
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
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Direct clipping of large basilar trunk aneurysm
Toshikazu Kimura1, Daichi Nakagawa, Kensuke Kawai
1Department of Neurosurgery, NTT Medical Center Tokyo; and.
Neurosurgical Focus
|January 3, 2015
Summary
A large basilar trunk aneurysm was incidentally discovered in an asymptomatic 77-year-old woman. Surgical clipping was successfully performed via an anterior temporal approach, addressing potential risks indicated by MRI findings.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Neuroradiology
Background:
- Incidental discovery of large basilar trunk aneurysms can pose diagnostic and therapeutic challenges.
- Brainstem high signal intensity on MRI FLAIR images adjacent to an aneurysm may indicate inflammatory or ischemic changes.
- Asymptomatic aneurysms require careful risk-benefit assessment for intervention.
Observation:
- A 77-year-old woman presented with headache, leading to the incidental finding of a large basilar trunk aneurysm.
- Magnetic Resonance Imaging (MRI) revealed high signal intensity in the brainstem adjacent to the aneurysm on Fluid-Attenuated Inversion Recovery (FLAIR) sequences.
Findings:
- The patient was otherwise healthy, with the aneurysm being asymptomatic at the time of discovery.
- Surgical clipping was chosen as the treatment modality.
Implications:
- This case highlights the successful surgical management of an incidentally discovered, large basilar trunk aneurysm.
- Early detection and intervention, even in asymptomatic cases with suggestive imaging findings, can be crucial for preventing future complications.
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