Surgical approaches to basilar bifurcation aneurysms.

Basilar bifurcation aneurysms are technically challenging and their treatment is often associated with greater morbidity than aneurysms located in the anterior circulation. These lesions can be treated using surgical, endovascular, or a combination of techniques. Several surgical approaches have evolved to treat basilar bifurcation aneurysms; none, however, is suitable for all aneurysms in this location. This article reviews the natural history, clinical presentation, evaluation, and selection of treatment approach and details various surgical techniques. The use of endovascular techniques is reviewed briefly.