Abordagem atual aos aneurismas do topo da artéria basilar

摘要: Approaches to the basilar artery aneurysm Objective: To review main approaches aneurysms and discuss relevant anatomy angiographic features choose appropriate approach in each case. Methods: Literature author's experiences are presented. Results: Current regarding level of lesion from sellae dorsum are: Kawase transpetrosous for lower, transcavernous middle temporopolar higher positioned aneurysms. Doppler, electroencephalography, somatosensory motor evoked potential might minimize incidence ischemic complications attributable prolonged temporary occlusion or inadvertent perforator occlusion. Circulatory arrest hypotermia may be considered giant complex The principle applied is maximization bone resection, which facilitates use surgical instruments minimizes brain retraction. Complex frequently outdo endovascular treatment. Conclusion: There a tendency literature consider surgery as an outdated method; however, technology intensive care anesthesia protection, techniques clips evolution indispensable manipulate angry after subarachnoid hemorrhage. Endovascular procedures do not remove clots cisterns avoid vasospasm, treat hydrocephalus fenestrate lamina terminalis same purpose; besides, longer follow up necessary according final result. neurosurgeon must dominate both treatment options able differentiate exact indications.