Advanced Micro-Neurosurgery in Treating Basilar Aneurysms

Microsurgical clipping of basilar apex aneurysms continues to be demanding in terms of anatomical knowledge and technical proficiency. Nevertheless, when done at an advanced level, it promises a safer and long-lasting treatment compared to other modalities. Starting with the subtemporal and pterional approaches, the modern transcavernous approach combines the advantages of both and has evolved to include significant extensions that would allow wider exposure to most complex aneurysms. The clipping technique is facilitated by the gained space but should be meticulously strategized to maintain control of the aneurysm while preserving the surrounding perforators.