Posterior circulation aneurysms have a higher tendency to rupture and become symptomatic in comparison to anterior circulation aneurysms. Current treatment modalities for aneurysms in these locations vary widely including microsurgical clipping, trapping with bypass, wrapping, and various endovascular methods such as coiling, balloon or stent-assisted coiling, flow diversion, and vessel sacrifice, among others.Overall, surgical versus endovascular treatment of posterior circulation aneurysms continue to be a controversial topic in cerebrovascular neurosurgery. At our center, multi-disciplinary assessments including surgeons capable of both endovascular and microsurgical treatments of these aneurysms are employed to guide the treatment strategies. As advancements in both fields are made, this will continue to be a topic for debate. Anatomy and individual patient's characteristics will dictate the correct approach and therefore proficiency in the microsurgical techniques required to treat these aneurysms will continue to be both relevant and important.
Keywords: Basilar artery; Cerebral aneurysm; Microsurgery; Posterior circulation; Subarachnoid hemorrhage; Vertebral artery.
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