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| Name | Subtemporal approach for distal basilar occlusion for giant aneurysm |
| Video Uploader | Video From American Association of Neurological Surgeons |
| Upload Date | This Video Uploaded At 22-05-2015 14:39:24 |
| Video Discription | Giuseppe Lanzino, M.D., Delia Cannizzaro, M.D., and Stefano Lorenzo Villa, M.D. Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota We described the subtemporal approach, which was used for distal basilar artery occlusion in a patient with a symptomatic giant unclippable aneurysm. We discuss issues related to positioning and lumbar drainage. We illustrate the basic steps: identification of the tentorial notch; sharp opening of the arachnoid behind the third nerve; placement of a fixed mechanical retractor to “hold” the brain; identification of the third nerve and mobilization from arachnoid attachments; identification of the course and insertion of the fourth nerve; division and retraction of the tentorial edge to enhance exposure; preparation of the “perforator-free zone”; and final clip application followed by ICG fluorescein angiography. We show some of the areas exposed with this approach. |
| Category | Education |
| Tags | Aneurysm (Disease Or Medical Condition) | Basilar Artery (Artery) | tentorial edge | unclippable | AANS | JNS | Journal of Neurosurgery |
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