[The limits and countermeasures of the anterior temporal approach for unruptured upper basilar artery aneurysms].

BACKGROUND AND PURPOSE: In general, upper basilar artery aneurysms are treated following the transsylvian or subtemporal approach. These approaches have both advantages and disadvantages. Therefore, we followed the anterior temporal approach that provides a wider surgical field in the retro-carotid space. METHODS: We reviewed the clinical records of 37 patients with an upper basilar artery aneurysm operated on following the anterior temporal approach between 2002 and 2012 in our institute, and evaluated the usefulness of this approach. RESULTS: In 23 cases, several additional techniques were performed. In all these cases a wide operation field was obtained in the retro-carotid space and the aneurysm was completely obliterated. The post operative adverse events were temporary oculomotor palsy in 6 cases, permanent oculomotor palsy in 3 and temporary epilepsy, aphasia due to venous infarction and asymptomatic cerebral infarction in 1 case each. CONCLUSIONS: The anterior temporal approach allows the additional use of several techniques and provides a wide surgical field. Therefore, we consider this approach is useful to reach and treat upper basilar artery aneurysms.