Specifics of Treatment for Basilar Trunk Artery Aneurysms

Abstract The estimated prevalence of intracranial aneurysms (IAs) in the general population ranges between 2% and 4% based on the radiographic and autopsy studies. The aneurysms of the posterior circulation account for 15% of all IAs and have a higher risk of rupture compared with those located in the anterior circulation. The basilar trunk artery is the segment in between the vertebrobasilar junction up to the superior cerebellar artery and the aneurysms located in this segment are extremely rare, constituting less than 1% of all IAs. In this chapter, we discuss their anatomical features and explore the pathophysiological mechanisms contributing to these lesions. Current evidence regarding surgical and endovascular interventions are examined. Although there is no consensus regarding the optimal treatment for lesions at the basilar trunk, decision is made on a case-by-case basis with extrapolation and assumptions based on results from the treatment for other cerebral aneurysms.