“Half Tran-Sylvian and Half Subtemporal Approach” for Microsurgical Clipping of Posterior Cerebral Artery Aneurysm

Skull base techniques remain relevant for treating posterior circulation aneurysms in the endovascular era. The “half trans-sylvian and half subtemporal approach” widens the window toward the basilar quadrification. A 63-year-old male presented with a Hunt Hess II SAH from a left PCA aneurysm with the SCA originating from the aneurysm neck. The patient underwent an orbitopterional craniotomy, anterior and posterior clinoidectomy, cutting of the tentorial edge, and clipping of the aneurysm.