Microsurgical Clipping of Basilar Apex Aneurysms: A Systematic Historical Review of Approaches and their Results

Transsylvian, pretemporal, and subtemporal approaches showed favorable neurologic outcomes at similar rates and were applied for aneurysms located between −1mm and +7mm in relation to the posterior clinoid process. The pretemporal approach was preferably applied to large and giant aneurysms with good outcome; the transsylvian approach was most frequently used for ruptured aneurysms.