Posterior cerebral artery aneurysm on P_2 segment

Objective The P 2 segment of the posterior cerebral artery(PCA) has been a challenging region to be exposed surgically. The clinical and surgical treatment of the aneurysms on the P 2 segment of the posterior cerebral artery was retrospectively reviewed in 11 patients.Methods Ten of 11 P 2 segment aneurysms were surgically treated with 6 cases via subtemporal and 4 via pterional approach. Five aneurysms were successfully treated by clipping the aneurysmal neck with parent artery patent, five giant aneurysms were treated by trapping, and the other one was treated with intraaneurysm coils.Results Eight of 10 operated patients had postoperative good recovery, 5 patients with clipping of aneurismal neck and 3 patients with aneurysm trapping. Ischemic infarct in the PCA territory occurred in 2 patients with aneurysm trapping. The other one with endovascular coils had a good result.Conclusion The aneurysms on the P 2 segment of the posterior cerebral artery had a tendency to become large or giant. The exposure of these aneurysms could be gained via pterional approach for the aneurysms on the anterior P 2 segment and via subtemporal approach for the aneurysms on the posterior P 2 segment.