Abstract
The history of surgical treatment of aneurysms in the posterior circulation is much shorter than that in the anterior circulation, probably because of the later development of routine vertebral angiography and the prognostic uncertainty due to their rarity (1). Besides, the intimate involvement of vertebral or basilar arteries with the brain stem and cranial nerves as well as the hidden midline position or other unfavorable locations of these aneurysms have made surgeries more technically demanding and neurosurgeons reluctant to operate on them.
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References
Drake CG (1979) The treatment of aneurysms of the posterior circulation. Clin Neurosurg 26:96–144.
Schwartz HG (1948) Arterial aneurysm of the posterior fossa. J Neurosurg 5:312–16.
Wells HG (1922) Intracranial aneurysm of the vertebral artery. Arch Neurol Psychiat 7:311–20.
Guillain G, Schmite P, Bertrand I (1930) Anévrysme du tronc basilaire ayant déterminé la symptomatologie d’une tumeur de l’angle ponto-cérébelleux. Rev Neurol 1:795–802.
Tönnis W (1937) Zür behandlung intrakräniellar aneurysmen. Arch Klin Chir 189:474–6.
Dandy WE (1944) Intracranial arterial aneurysms. Comstock, Ithaca,New York, p 60–6; 130–2.
Yamaura A (1986) Technical note for safe surgery of posterior circulation aneurysms. In: Kikuchi H, Fukushima T, Watanabe K (eds) Intracranial aneurysms-surgical timing and techniques. Nishimura, Tokyo, p. 353.
Rizzoli HV, Hayes GJ (1953) Congenital berry aneurysm of the posterior fossa: case report with successful operative excision. J Neurosurg 10:550–1.
Paulson G, Nashold BS Jr., Margolis G (1959) Aneurysms of the vertebral artery: report of 5 cases. Neurology 9:590–8.
Desaussure RL, Hunter SE, Robertson JT (1958) Saccular aneurysms of the posterior fossa. J Neurosurg 15:385–91.
Sedzimir CB (1963) Surgical treatment of aneurysms of the vertebral artery. J Neurosurg 20:597–9.
Jamieson KG (1964) Aneurysms of the vertebrobasilar system: surgical intervention in 19 cases. J Neurosurg 21:781–97.
Drake CG (1984) Gordon Murray lecture: evolution of intracranial aneurysm surgery. Can J Surg 27:549–55.
Alexander W (1882) The treatment of epilepsy by ligature of the vertebral arteries. Brain 5:170–87.
Logue V (1958) The surgical treatment of aneurysms in the posterior fossa. J Neurol Neurosurg Psychiatry 21:66–7.
Cushing HW (1911) The control of bleeding in operations for brain tumors with the description of silver “clips” for the occlusion of vessels inaccessible to the ligature. Ann Surg 54:1–19.
Matas R, Allen CW (1911) Occlusion of large surgical arteries with removable metallic bands to test the efficiency of the collateral circulation: experimental and clinical observations. JAMA 56:233.
Bakay L, Sweet WH (1953) Intra-arterial pressures in the neck and brain: late changes after carotid closure, acute measurements after vertebral closure. J Neurosurg 10:353–9.
Yasargil MG, Krayenblihl HA, Jacobson JH II (1970) Microneurosurgical arterial reconstruction. Surgery 67:221–33.
Ausman JI, Nicoloff DM, Chou SN (1978) Posterior fossa revascularization: anastomosis of vertebral artery to PICA with interposed radial artery graft. Surg Neurol 9:281–6.
Sundt TM Jr, Piepgras DG, Houser OW, Campbell JK (1982) Interposition saphenous vein grafts for advanced occlusive disease and large aneurysms in the posterior circulation. J Neurosurg 56:205–15.
Yasargil MG, Vise WM, Bader DC (1977) Technical adjuncts in neurosurgery. Surg Neurol 8:331–6.
Rand RW, Jannetta PJ (1967) Micro-neurosurgery for aneurysms of the vertebral-basilar artery system. J Neurosurg 27:330–5.
Stehbens WE (1972) Pathology of the cerebral blood vessels. CV Mosby, St Louis, pp. 60–97, 99–130, 351–470.
Hayes WT, Bernhardt H, Young JM (1967) Fusiform arteriosclerotic aneurysm of the basilar artery. Vasc Surg 1:171–8.
Echiverri HC, Rubino FA, Gupta SR, Gujrati M (1989) Fusiform aneurysm of the vertebrobasilar arterial system. Stroke 20:1741–7.
Drake CG, Peerless SJ (1997) Giant fusiform intracranial aneurysms: review of 120 patients treated surgically from 1965 to 1992. J Neurosurg 87:141–62.
Mizutani T (1996) A fatal, chronically growing basilar artery: a new type of dissecting aneurysm. J Neurosurg 84:962–71.
Read D, Esiri MM (1979) Fusiform basilar artery aneurysm in a child. Neurology 29:1045–9.
Shokunbi MT, Vinters HV, Kaufmann JC (1988) Fusiform intracranial aneurysms: clinicopathologic features. Surg Neurol 29:263–70.
Nakatomi H, Segawa H, Kurata A, et al. (2000) Clinico-pathological study of intracranial fusiform and dolichoectatic aneurysms: insight on the mechanism of growth. Stroke 31:896–900.
Mizutani T, Aruga T (1992) “Dolichoectatic” intracranial vertebrobasilar dissecting aneurysm. Neurosurgery 31:765–73.
Friedman AH, Drake CG (1984) Subarachnoid hemorrhage from intracranial dissecting aneurysm. J Neurosurg 60:325–34.
Shimoji T, Bando K, Nakajima K, Ito K (1984) Dissecting aneurysm of the vertebral artery: report of seven cases and angiographic findings. J Neurosurg 61:1038–46.
Mizutani T, Miki Y, Kojima H, Suzuki H (1999) Proposed classification of nonatherosclerotic cerebral fusiform and dissecting aneurysms. Neurosurgery 45:253–60.
McDonald CA, Korb M (1939) Intracranial aneurysms. Arch Neurol Psychiat 42:298–328.
Pandey AS, Koebbe C, Rosenwasser RH, Veznedaroglu E (2007) Endovascular coil embolization of ruptured and unruptured posterior circulation aneurysms: review of a 10-year experience. Neurosurgery 60:626–37.
Jellinger Kurt (1979) Pathology and aetiology of intracranial aneurysms. In: Pia HW, Langmaid C, Zierski J (ed.) Cerebral Aneurysms. Springer-Verlag, Berlin, Heidelberg, New York, p. 5.
Peluso JP, van Rooij WJ, Sluzewski M, Beute GN (2007) Aneurysms of the vertebrobasilar junction: incidence, clinical presentation, and outcome of endovascular treatment. AJNR Am J Neuroradiol 28:1747–51.
Lin CF, Hsu SP, Chen MT, Chen HH, Shih YH, Lee LS, Chen MH (2007) Posterior inferior cerebellar artery with extracranial origin harboring an extracranial aneurysm. Surg Neurol 68(Suppl l):S64–7.
Peluso JP, van Rooij WJ, Sluzewski M, Beute GN, Majoie CB (2008) Posterior inferior cerebellar artery aneurysms: incidence, clinical presentation, and outcome of endovascular treatment. AJNR Am J Neuroradiol 29:86–90.
D’Ambrosio AL, Kreiter KT, Bush CA, Sciacca RR, Mayer SA, Solomon RA, Connolly ES Jr. (2004) Far lateral suboccipital approach for the treatment of proximal posteroinferior cerebellar artery aneurysms: surgical results and long-term outcome. Neurosurgery 55:39–54.
Anson JA, Lawton MT, Spetzler RF (1996) Characteristics and surgical treatment of dolichoectatic and fusiform aneurysms. J Neurosurg 84:185–93.
Andoh T, Shirakami S, Nakashima T, Nishimura Y, Sakai N, Yamada H, Ohkuma A, Tanabe Y, Funakoshi T (1992) Clinical analysis of a series of vertebral aneurysm cases. Neurosurgery 31:987–93.
Miyazaki S, Yamaura A, Kamata K, Fukushima H (1984) A dissecting aneurysm of the vertebral artery. Surg Neurol 21:171–4.
Santos-Franco JA, Zenteno M, Lee A (2008) Dissecting aneurysms of the vertebrobasilar system: a comprehensive review on natural history and treatment options. Neurosurg Rev 31:131–40.
Yamaura A, Watanabe Y, Saeki N (1990) Dissecting aneurysms of the intracranial vertebral artery. J Neurosurg 72:183–8.
Richardson AE (1968) The natural history of patients with intracranial aneurysms after rupture. Prog Brain Res 30:269–73.
Sahs AL, Perret GE, Locksley HB (1969) Intracranial aneurysms and subarachnoid hemorrhage: a cooperative study. JB Lippincott, Philadelphia
Logue V (1964) Posterior fossa aneurysms. Clin Neurosurg 11:183–207.
Flemming KD, Wiebers DO, Brown RD Jr, Link MJ, Huston J 3rd, McClelland RL, Christianson TJ (2005) The natural history of radiographically defined vertebrobasilar nonsaccular intracranial aneurysms. Cerebrovasc Dis 20:270–9.
Yu YL, Moseley IF, Pullicino P, McDonald WI (1982) The clinical picture of ectasia of the intracerebral arteries. J Neurol Neurosurg Psychiatry 45:29–36.
Albuquerque FC, Fiorella DJ, Han PP, Deshmukh VR, Kim LJ, McDougall CG (2005) Endovascular management of intracranial vertebral artery dissecting aneurysms. Neurosurg Focus 18:E3.
Yamada M, Kitahara T, Kurata A, Fujii K, Miyasaka Y (2004) Intracranial vertebral artery dissection with subarachnoid hemorrhage: clinical characteristics and outcomes in conservatively treated patients. J Neurosurg 101:25–30.
Mizutani T, Aruga T, Kirino T, Miki Y, Saito I, Tsuchida T (1995) Recurrent subarachnoid hemorrhage from untreated ruptured vertebrobasilar dissecting aneurysms. Neurosurgery 36:905–11.
Dimsdale H, Logue V (1959) Ruptured posterior fossa aneurysms and their surgical treatment. J Neurol Neurosurg Psychiatry 22:202–17.
Krayenblihl H, Yasargil MG (1957) Die vaskularen erkrankungen im gebiet der arteria vertebralis und arteria basialis. Georg Thieme Verlag, Stuttgart.
Steinberger A, Ganti SR, McMurtry JG 3rd, Hilal SK (1984) Transient neurological deficits secondary to saccular vertebrobasilar aneurysms: report of two cases. J Neurosurg 60:410–13.
Nishizaki T, Tamaki N, Takeda N (1986) Dolichoectatic basilar artery: a review of 23 cases. Stroke 17:1277–81.
Coert BA, Chang SD, Do HM, Marks MP, Steinberg GK (2007) Surgical and endovascular management of symptomatic posterior circulation fusiform aneurysms. J Neurosurg 106:855–65.
Yonas H, Agamanolis D, Takaoka Y, White RJ (1977) Dissecting intracranial aneurysms. Surg Neurol 8:407–15.
Sasaki O, Ogawa H, Hoike T, Koizumi T, Tanaka R (1991) A clinicopathological study of dissecting aneurysms of the intracranial vertebral artery. J Neurosurg 75:874–82.
Ruigrok YM, Rinkel GJ, Buskens E, Velthuis BK, van Gijn J (2000) Perimesencephalic hemorrhage and CT angiography: A decision analysis. Stroke 31:2976–83.
Hudgins RJ, Day AL, Quisling RG, Rhoton AL Jr., Sypert GW, Garcia-Bengochea F (1983) Aneurysms of the posterior inferior cerebellar artery. A clinical and anatomical analysis. J Neurosurg 58:381–7.
Matsumoto M, Sato M, Nakano M, Endo Y, Watanabe Y, Sasaki T, Suzuki K, Kodama N (2001) Three-dimensional computerized tomographic angiography-guide surgery of acutely ruptured cerebral aneurysms. J Neurosurg 94:718–27.
Velthuis BK, van Leeuwen MS, Witkamp TD, Ramos LM, Berkelbach van Der Sprenkel JW, Rinkel GJ (1999) Computerized tomography angiography in patients with subarachnoid hemorrhage: from aneurysm detection to treatment without conventional angiography. J Neurosurg 91:761–7.
Villavicencio AT, Gray L, Leveque JC, Fukushima T, Kureshi S, Friedman AH (2001) Utility of three-dimensional computed tomographic angiography for assessment of relationships between the vertebrobasilar system and the cranial base. Neurosurgery 48:318–27.
Jäger HR, Ellamushi H, Moore EA, Grieve JP, Kitchen ND, Taylor WJ (2000) Contrast-enhanced MR angiography of intracranial giant aneurysms. AJNR Am J Neuroradiol 21:1900–07.
Nael K, Villablanca JP, Saleh R, Pope W, Nael A, Laub G, Finn JP (2006) Contrast-enhanced MR angiography at 3T in the evaluation of intracranial aneurysms: a comparison with time-of-flight MR angiography. AJNR Am J Neuroradiol 27:2118–121.
Iwama T, Andoh T, Sakai N, Iwata T, Hirata T, Yamada H (1990) Dissecting and fusiform aneurysms of vertebrobasilar systems: MR imaging. Neuroradiology 32:272–9.
Mascalchi M, Bianchi MC, Mangiafico S, Ferrito G, Puglioli M, Marin E, Mugnai S, Canapicchi R, Quilici N, Inzitari D (1997) MRI and MR angiography of vertebral artery dissection. Neuroradiology 39:329–40.
Pelkonen O, Tikkakoski T, Leinonen S, Pyhtinen J, Lepojarvi M, Sotaniemi K (2003) Extracranial internal carotid and vertebral artery dissections: angiographic spectrum, course and prognosis. Neuroradiology 45:71–7.
Rothman SLG, Azar-Kia B, Kier EL, Schechter MM, Allen WE III (1973) The angiography of posterior inferior cerebellar artery aneurysms. Neuroradiology 6:1–7.
Liew D, Ng PY, Ng I (2004) Surgical management of ruptured and unruptured symptomatic posterior inferior cerebellar artery aneurysms. Br J Neurosurg 18:608–12.
Yamaura A (1988) Diagnosis and treatment of vertebral aneurysms. J Neurosurg 69:345–9.
Yasargil MG, Antic J, Laciga R, et al. (1976) Microsurgical pterional approach to aneurysms of the basilar bifurcation. Surg Neurol 6:83–91.
Krisht AF, Kadri PA (2005) Surgical clipping of complex basilar apex aneurysms: a strategy for successful outcome using the pretemporal transzygomatic transcavernous approach. Neurosurgery 56(2 Suppl):261–73.
Krisht AF (2005) Transcavernous approach to diseases of the anterior upper third of the posterior fossa. Neurosurg Focus 19:E2.
Hammon WM, Kempe LG (1972) The posterior fossa approach to aneurysms of the vertebral and basilar arteries. J Neurosurg 37:339–47.
Peerless SJ, Drake CG (1988) Surgical techniques of posterior cerebral aneurysms. In: Schmidek HH, Sweet WH (eds) Operative neurosurgical techniques, indications, methods, and results. WB Saunders Co, Philadelphia
Heros RC (1986) Lateral suboccipital approach for vertebral and vertebrobasilar artery lesions. J Neurosurg 64:559–62.
Spetzler RF, Grahm TW (1990) The far-lateral approach to the inferior clivus and the upper cervical region: technical note. BNI Quarterly 6:35–8.
Wen HT, Rhoton AL Jr., Katsuta T, de Oliveira E (1997) Microsurgical anatomy of the transcondylar, supracondylar, and paracondylar extensions of the far-lateral approach. J Neurosurg 87:555–85.
Al-Mefty O, Fox JL, Smith RR (1988) Petrosal approach for petroclival meningiomas. Neurosurgery 22:510–17.
Spetzler RF, Daspit CP, Pappas CT (1992) The combined supra-and infratentorial approach for lesions of the petrous and clivai regions: experience with 46 cases. J Neurosurg 76:588–99.
Seifert V, Stolke D (1996) Posterior transpetrosal approach to aneurysms of the basilar trunk and vertebrobasilar junction. J Neurosurg 85:373–9.
Krayenbühl N, Guerrero C, Krisht AF (2005) Technical strategies to approach aneurysms of the vertebral and posterior inferior cerebellar arteries. Neurosurg Focus 19:E4.
Yamaura A, Ise H, Makino H (1981) Radiometric study on posterior inferior cerebellar aneurysms with special reference to accessibility by the lateral suboccipital approach. Neurol Med Chir 21:721–33.
Day JD (2004) Intradural jugular tubercle reduction to enhance exposure via the transcondylar approach: technical note. Neurosurgery 55:247–51.
Salas E, Sekhar LN, Ziyal IM, et al. (1999) Variations of the extreme lateral craniocervical approach: Anatomical study and clinical analysis of 69 patients. J Neurosurg 90(Suppl 4):206–21.
Bertalanffy H, Seeger W (1991) The dorsolateral, suboccipital, transcondylar approach to the lower clivus and anterior portion of the craniocervical junction. Neurosurgery 29:815–21.
Matsushima T, Matsukado K, Natori Y, et al. (2001) Surgery on a saccular vertebral artery-posterior inferior cerebellar artery aneurysm via the transcondylar fossa (supracondylar transjugular tubercle) approach or the transcondylar approach: Surgical results and indications for using two different lateral skull base approaches. J Neurosurg 95:268–74.
Krayenbühl N, Hafez A, Hernesniemi JA, Krisht AF (2007) Taming the cavernous sinus: technique of hemostasis using fibrin glue. Neurosurgery 61(3 Suppl):E52.
Sekhar LN, Natarajan SK, Manning T, Bhagawati D (2007) The use of fibrin glue to stop venous bleeding in the epidural space, vertebral venous plexus, and anterior cavernous sinus: technical note. Neurosurgery 61(3 Suppl):E51.
Drake CG, Peerless SJ, Hernesniemi JA (1996) Surgery of vertebrobasilar aneurysms, London, Ontario experience on 1767 patients. Springer, Wien New York.
Peerless SJ, Hernesniemi JA, Gutman FB, Drake CG (1994) Early surgery for ruptured vertebrobasilar aneurysms. J Neurosurg 80:643–9.
Peerless SJ, Hernesniemi JA, Drake CG (1996) Posterior circulation aneurysms. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill, New-York, pp. 2341–56.
Yasargil MG (1984) Microneurosurgery vol 2. Clinical considerations, surgery of the intracranial aneurysms and results. Thieme, Stuttgart.
Heros R (1995) Aneurysms of the vertebral artery and its branches. In: Ojemann RG (ed) Surgical management of neurovascular disease. Williams & Wilkins, Baltimore, pp. 291–304.
Seifert V, Raabe A, Stolke D (2001) Management-related morbidity and mortality in unselected aneurysms of the basilar trunk and vertebrobasilar junction. Acta Neurochir (Wien) 143:343–9.
Lister JR, Rhoton AL Jr., Matsushima T, Peace DA (1982) Microsurgical anatomy of the posterior inferior cerebellar artery. Neurosurgery 10:170–99.
Al-Khayat H, Al-Khayat H, Beshay J, et al. (2005) Vertebral artery-posteroinferior cerebellar artery aneurysms: clinical and lower cranial nerve outcomes in 52 patients. Neurosurgery 56:2–11.
Lewis SB, Chang DJ, Peace DA, et al. (2002) Distal posterior inferior cerebellar artery aneurysms: clinical features and management. J Neurosurg 97:756–66.
Horiuchi T, Tanaka Y, Hongo K, et al. (2003) Characteristics of distal posteroinferior cerebellar artery aneurysms. Neurosurgery 53:589–96.
Nishizaki T, Tamaki N, Nishida Y, et al. (1985) Aneurysms of the distal posterior inferior cerebellar artery: experience with three cases and review of the literature. Neurosurgery 16:829–32.
Beyerl BD, Heros RC (1986) Multiple peripheral aneurysms of the posterior inferior cerebellar artery. Neurosurgery 19:285–9.
Guglielmi G, Vinuela F, Duckwiler G, et al. (1992) Endovascular treatment of posterior circulation aneurysms by electrothrombosis using electrically detachable coils. J Neurosurg 77:515–24.
Nichols DA, Brown RD Jr., Thielen KR, et al. (1997) Endovascular treatment of ruptured posterior circulation aneurysms using electrolytically detachable coils. J Neurosurg 87:374–80.
Lempert TE, Malek AM, Halbach VV, et al. (2000) Endovascular treatment of ruptured posterior circulation cerebral aneurysms: clinical and angiographic outcomes. Stroke 31:100–10.
Mordasini P, Schroth G, Guzman R, et al. (2005) Endovascular treatment of posterior circulation cerebral aneurysms by using Guglielmi detachable coils: a 10-year single-center experience with special regard to technical development. AJNR Am J Neuroradiol 26:1732–8.
Mericle RA, Reig AS, Burry MV, Eskioglu E, Firment CS, Santra S (2006) Endovascular surgery for proximal posterior inferior cerebellar artery aneurysms: an analysis of Glasgow outcome score by Hunt-Hess grades. Neurosurgery 58:619–25.
Lozier AP, Connolly ES Jr., Lavine SD, Solomon RA (2002) Guglielmi detachable coil embolization of posterior circulation aneurysms: a systemic review of the literature. Stroke 33:2509–18.
Groden C, Regelsberger J, Neumaier-Probst E, Grzyska U, Herrmann HD, Zeumer H (2000) Operative or endovascular treatment of ruptured intracranial vertebral artery aneurysms? Neuroradiology 42:685–91.
Fiorella D, Albuquerque FC, Masaryk TJ, Rasmussen PA, McDougall CG (2005) Balloon-in-stent technique for the constructive endovascular treatment of “ultra-wide necked” circumferential aneurysms. Neurosurgery 57:1218–27.
Park HK, Horowitz M, Jungreis C, Genevro J, Koebbe C, Levy E, Kassam A (2005) Periprocedural morbidity and mortality associated with endovascular treatment of intracranial aneurysms. AJNR Am J Neuroradiol 26:506–14.
Evans JJ, Sekhar LN, Rak R, Stimac D (2004) Bypass grafting and revascularization in the management of posterior circulation aneurysms. Neurosurgery 55:1036–49.
Baldwin HZ, Spetzler RF, Wascher TM, Daspit CP (1995) The far lateral-combined supra-and infratentorial approach: clinical experience. Acta Neurochir (Wien) 134:155–8.
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Hsu, S.P.C., Krisht, A.F. (2011). Aneurysms of the vertebral artery. In: Pathology and surgery around the vertebral artery. Springer, Paris. https://doi.org/10.1007/978-2-287-89787-0_35
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