Abstract

• This report is made to investigate the clinical trend and actual conditions of vertebrobasilar aneurysm surgery in Korea. The author reports a series of 4 surgical cases of vertebrobasilar aneurysm not located at the basilar bifurcation, one on the basilar origin of the superior cerebellar artery, two on the vertebral origin of the posterior inferior cerebellar artery, and one on the posterior inferior cerebellar artery. Included in this series are all the cases of vertebrobasilar aneurysm operated upon at the university hospitals, Seoul, Korea.
  Regardless of the clinical picture, an initial four-vessel angiographic study in all subarachnoid hemorrhages should be performed to visualize the posterior circulation and particularly both posterior inferior cerebellar arteries.
  It is the author's conviction that the microvascular anatomy of the posterior part of the circle of Willis is important in vertebrobasilar aneurysm surgery.
  The author realizes that vertebrobasilar aneurysm surgery is technically more demanding, since use of the operating microscope and familiarity with microsurgical techniques are essential in its execution.