Exposure of the vertebrobasilar artery junction with traction of the dentate ligament for the treatment of large vertebral artery aneurysms

Technical note

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✓ A technique for exposing the vertebrobasilar junction with traction of the dentate ligament is described for treatment of large vertebral artery (VA) aneurysms via the far lateral suboccipital approach with partial condylar resection. The most rostral attachment of the dentate ligament is divided above the site where the VA pierces the dura mater. A traction suture is placed into the dentate ligament and gently retracted using mosquito forceps. As a result, the medulla oblongata is lifted dorsally and slightly rotated by the divided and retracted dentate ligament, allowing an approach from a more superior or inferior direction. The present technique is useful for the treatment of large thrombosed VA aneurysms.

Abbreviations used in this paper: CN = cranial nerve; MR = magnetic resonance; VA = vertebral artery.
Article Information

Contributor Notes

Address correspondence to: Hiroshi Kashimura, M.D., Department of Neurosurgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan. email: hkashi@iwate-med.ac.jp.

© AANS, except where prohibited by US copyright law.

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