Level-3 Pretemporal Transcavernous Approach to Clip a Low-Lying Basilar Tip Aneurysm

Area of Science:

• Neurosurgery
• Vascular Neurology
• Surgical Techniques

Background:

• Basilar artery aneurysms (BAA) are rare but critical cerebrovascular lesions.
• Ruptured BAAs carry a high risk of catastrophic neurological outcomes.
• Low-lying BAAs present unique surgical challenges.

Purpose of the Study:

• To present a case of a ruptured low-lying basilar tip aneurysm treated surgically.
• To evaluate the efficacy of the Level 3 pretemporal transcavernous approach for BAA clipping.
• To demonstrate the surgical technique in a clinical video presentation.

Main Methods:

• A 60-year-old female patient with a ruptured low-lying basilar tip aneurysm (Hunt and Hess grade IV) was treated.
• A frontotemporal craniotomy was performed, utilizing the Level 3 pretemporal transcavernous approach.
• Surgical clipping of the basilar artery aneurysm was successfully achieved.

Main Results:

• The patient experienced an uneventful recovery following the surgical intervention.
• At 3-month follow-up, the patient was functionally independent.
• The Level 3 pretemporal transcavernous approach proved effective for clipping the low-lying BAA.

Conclusions:

• The Level 3 pretemporal transcavernous approach is a valuable and effective surgical option for low-lying basilar tip aneurysms.
• This technique facilitates safe and successful clipping of challenging BAA.
• Successful surgical management leads to favorable patient outcomes and functional recovery.