MIDLINE ANEURYSMS OF THE VERTEBROBASILAR JUNCTION - AN EFFECTIVE ANTERIOR APPROACH

There are acknowledged difficulties associated with operations on midl ine aneurysms at the vertebrobasilar junction. This report describes a series of such aneurysms treated by an anterior approach using a Le F ort maxillotomy to gain access via the clivus to the aneurysm. In each case the aneurysm was dealt with satisfactorily with no long-term mor bidity or mortality. Attention is directed to the necessity for a wate r-tight dural seal postoperatively. We advocate wider use of this tech nique in appropriate circumstances.