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Transjugular tubercle-preaccessory approach for ventrocaudally located PICA aneurysm

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Abstract

Background

Posterior inferior cerebellar artery (PICA) aneurysms are often located in the ventral craniocervical junction. Such deep-seated aneurysms are usually treated with coil embolization. However, recurred and/or very small PICA aneurysms are hardly treated with an endovascular approach.

Method

We present a modification of the transcondylar fossa approach with intradural and extradural removal of the jugular tubercle. An adequate preaccessory surgical corridor was created with this novel technique.

Conclusion

The ventocaudal PICA aneurysm was clipped through the outside of the spinal accessory nerve without surgical manipulation of other lower cranial nerves. This approach is worthwhile to avoid dysphagia.

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References

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Japan

    Tetsuyoshi Horiuchi, Alhusain Nagm, Takatoshi Hasegawa & Kazuhiro Hongo.

  2. Department of Neurosurgery, Al-Azhar University Faculty of Medicine-Nasr city, Cairo, Egypt

    Alhusain Nagm

Authors
  1. Tetsuyoshi Horiuchi
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  2. Alhusain Nagm
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  3. Takatoshi Hasegawa
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  4. Kazuhiro Hongo.
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Corresponding author

Correspondence to Tetsuyoshi Horiuchi.

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Conflicts of Interest

We have no potential conflict of interest.

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The video shows the present surgical technique of the transjugular tubercle-preaccessory route for ventrocaudally located PICA aneurysm. (MP4 184159 kb)

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Horiuchi, T., Nagm, A., Hasegawa, T. et al. Transjugular tubercle-preaccessory approach for ventrocaudally located PICA aneurysm. Acta Neurochir 159, 641–644 (2017). https://doi.org/10.1007/s00701-017-3126-z

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  • DOI: https://doi.org/10.1007/s00701-017-3126-z

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