Extended retrosigmoid retrocondylar access in microsurgery of posterior inferior cerebellar artery aneurysms in the acute period of hemorrhage (clinical case)

Objective: using the example of clinical observation to describe the features of a new method of surgical treatment of aneurysms at the mouth of the posterior inferior cerebellar artery (PICA), in the area of the anterior and lateral medullary segments. Despite a wide range of traditional surgical and minidomes, there is no consensus on the choice of a particular access for cerebral aneurysms. Suggested indications and contraindications for aneurysm treatment methods vary from author to author. The extended retrosigmoid retrocondylar access we use is safe and effective and can be a good alternative in microsurgery of PICA aneurysms in the acute period of hemorrhage. In this clinical example we demonstrate a new surgical approach to the treatment of aneurysms in the PICA orifice based on the experience formed in the clinic with a significant volume of patients (more than 200 annually) operated on in the first 48 hours after hemorrhage, which can be used in practice and allows achieving the fastest early patient activation and reducing the period of medical and social rehabilitation.