A review of the management of 15 cases of aneurysms of the posterior cerebral artery.

The presenting features of 15 cases of posterior cerebral artery aneurysm are discussed. The use of the axial radiographic view in determining the anatomy of these aneurysms is highlighted. Ten out of 15 patients underwent surgery. In three patients the aneurysm was approached by the transzygomatic route, in six via the subtemporal route and in one using the pterional approach. There was no operative mortality. Nine out of 10 patients made good long-term recoveries following surgery, one patient remains moderately disabled. Three out of five patients in the non-surgical group made a good recovery. The advantages and disadvantages of the various operative approaches are discussed with particular reference to ease of access, brain retraction and adequate exposure of the aneurysm. It was possible to clip the aneurysm and spare the parent vessel in all three cases using the transzygomatic approach, but this was possible in only one of the remaining cases.