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Updated: Dec 9, 2025

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
How I do it: lateral supra-cerebellar infra-tentorial approach for P2-P3 junction cerebral aneurysms
Michel W Bojanowski1, Gilles El Hage2, Chiraz Chaalala2
1Division of Neurosurgery, Université de Montréal, University of Montreal Medical Center, 1051 Sanguinet street, Montreal, QC, H2X 3E4, Canada. michel.bojanowski.chum@ssss.gouv.qc.ca.
Background:
P2-P3 junction aneurysms are challenging to treat surgically because of their frequent complex morphology and their location deep in close proximity to the midbrain. The sub-temporal route requires significant retraction of the temporal lobe in addition to potential injury to the vein of Labbe. We describe the technique for treating such aneurysms via a lateral supra-cerebellar infra-tentorial (LSCIT) approach, which eliminates manipulation of the temporal lobe.
Method:
Cadaveric dissection provided comprehensive understanding of relevant anatomy. Intraoperative video shows clipping of the aneurysm using a LSCIT approach.
Conclusion:
LSCIT approach allows safe clipping of P2-P3 aneurysms with minimal brain manipulation.
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