[Selection of surgical approach to aneurysms of distal regions of the basilar artery].

Twenty-nine patients with basilar artery aneurysms were operated on using one of three approaches: pterional, orbitozygomatical, and subtemporal. The efficiency of surgery and the frequency of surgical complications are analyzed in detail in relation to the data of an angiographic study and the intraoperative pattern. Three (10.3%) patients died in the postoperative period. In most cases, the pterional approach is adequate for clipping almost any aneurysm of the distal portions of the basilar artery; the use of the orbitozygomatical approach in patients with aneurysm of the same location is determined by its extent and/or adhesions with the adjacent brain structures. Current neuroimaging techniques are of the most informative value in choosing a surgical treatment policy in each specific case.