CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(02): 321-326
DOI: 10.1055/s-0044-1786704
Case Report

Microneurosurgery for Ruptured Aneurysm of Distal Intracranial Vertebral Artery: A Case Report

Tushar V. Soni
1   Department of Neurosurgery, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India
1   Department of Neurosurgery, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India
Varshesh Shah
1   Department of Neurosurgery, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India
Sandip Singh
1   Department of Neurosurgery, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India
Nirav Shah
1   Department of Neurosurgery, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India
› Author Affiliations


The International Subarachnoid Aneurysm Trial led to a shift from clipping to endovascular coiling as the primary therapy for cerebral aneurysm particularly in the management of posterior circulation aneurysm. However, endovascular therapy is often unavailable in low-resource settings, emphasizing the importance of maintaining surgical skill sets in resource-poor countries. This article presents a detailed case report on the successful microneurosurgical management of a 65-year-old female with a history of headache and weakness with past history of hypertension and a right posterior cerebral artery territory infarct who was diagnosed with a ruptured aneurysm situated within the intracranial vertebral artery. Patient was operated with the far lateral approach and clipping of the aneurysm. This case report elucidates the intricate surgical techniques employed, and the challenges neurosurgeons encountered in treating posterior circulation intracranial aneurysms, particularly those with ruptured complications. The aneurysms' intricate anatomy and increased rupture risk necessitate a meticulous microneurosurgical approach. The severity of subarachnoid hemorrhage from ruptured aneurysms increases morbidity and mortality rates.

Publication History

Article published online:
09 May 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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