Transclival Approach and Reconstruction for a Vertebrobasilar Artery Aneurysm

Area of Science:

• Neurosurgery
• Vascular Neurosurgery
• Endoscopic Skull Base Surgery

Background:

• Craniocervical junction reconstruction presents significant surgical challenges.
• Endoscopic approaches for this region are not well-documented.
• Vertebrobasilar artery aneurysms require specialized treatment strategies.

Observation:

• A unique case of a de novo left vertebrobasilar artery aneurysm was identified.
• The aneurysm was located at the challenging craniocervical junction.
• An expanded endonasal transclival approach was utilized for treatment.

Findings:

• Successful treatment of the vertebrobasilar artery aneurysm was achieved.
• A rhinopharyngeal flap was employed for surgical exposure and reconstruction.
• This technique proved effective for managing complex craniocervical pathologies.

Implications:

• This case demonstrates the feasibility of endoscopic endonasal surgery for complex craniocervical aneurysms.
• The rhinopharyngeal flap offers a valuable reconstructive option in skull base surgery.
• Minimally invasive techniques can be expanded to treat challenging vascular lesions at the craniocervical junction.