Citations 2
Pretemporal (“Half-and-Half”) Approach for Posterior Circulation Aneurysms in a Patient With Internal Carotid Artery Occlusion
Cannizzaro, Delia , Villà, S., Meyer, Fredric B. , Villa, Stefano L, Lanzino, Giuseppe , Cannizzaro, Delia
Operative Neurosurgery | August 16, 2017 | Volume: 14 | Issue: 4 | Pages: 457-457
Subtemporal approach for distal basilar occlusion for giant aneurysm. Nuances and advantages of the subtemporal approach
Cannizzaro, Delia , Villà, S., Lanzino, Giuseppe , Cannizzaro, Delia
Neurosurgical Focus | January 2, 2015 | Volume: 38 | Issue: videosuppl1 | Pages: Video5
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. The video can be found here: http://youtu.be/S_NLIjKQL_o .