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Utility of three-dimensional computed tomographic angiography for assessment of relationships between the vertebrobasilar system and the cranial base.

Publication ,  Journal Article
Villavicencio, AT; Gray, L; Leveque, JC; Fukushima, T; Kureshi, S; Friedman, AH
Published in: Neurosurgery
February 2001

OBJECTIVE: The optimal surgical exposure for basilar tip aneurysms is dictated by the relationship of the basilar bifurcation to the cranial base. This study was designed to evaluate three-dimensional computed tomographic angiography as a means of obtaining detailed anatomic information on the basilar artery and the surrounding cranial base in individual patients before surgery. METHODS: We studied 30 patients using three-dimensional computed tomographic angiographic reconstructions from 1-mm computed tomographic slices. Detailed anatomic measurements were performed to define the relationship between the basilar artery and the cranial base. Particular attention was paid to the height of the dorsum sellae and its relationship to the basilar bifurcation. RESULTS: The heights of the basilar apex and the vertebrobasilar junction, relative to the cranial base, were extremely variable. Considerable asymmetries in the heights of the left and right posterior clinoid processes were identified; in one case, this difference was more than 1 cm (mean difference in height, 0.9 mm; range, 0-10.3 mm). The heights of the posterior clinoid processes above the sellar floor ranged from 5.8 to 14.1 mm (mean height, 9.5 mm). We were able to determine the feasibility of the pterional/orbitozygomatic, middle fossa/ anterior petrosal, and presigmoid retrolabyrinthine approaches to an individual basilar bifurcation. We also estimated the amount of bone removal required and determined the operative distances via those approaches. CONCLUSION: Three-dimensional computed tomographic angiography is a useful tool for assessing critical anatomic relationships and represents an adjunct to conventional angiography in the planning of individualized, precisely tailored, cranial base approaches to the vertebrobasilar system.

Duke Scholars

Published In

Neurosurgery

DOI

ISSN

0148-396X

Publication Date

February 2001

Volume

48

Issue

2

Start / End Page

318 / 326

Location

United States

Related Subject Headings

  • Vertebral Artery
  • Tomography, X-Ray Computed
  • Skull Base
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Imaging, Three-Dimensional
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Villavicencio, A. T., Gray, L., Leveque, J. C., Fukushima, T., Kureshi, S., & Friedman, A. H. (2001). Utility of three-dimensional computed tomographic angiography for assessment of relationships between the vertebrobasilar system and the cranial base. Neurosurgery, 48(2), 318–326. https://doi.org/10.1097/00006123-200102000-00014
Villavicencio, A. T., L. Gray, J. C. Leveque, T. Fukushima, S. Kureshi, and A. H. Friedman. “Utility of three-dimensional computed tomographic angiography for assessment of relationships between the vertebrobasilar system and the cranial base.Neurosurgery 48, no. 2 (February 2001): 318–26. https://doi.org/10.1097/00006123-200102000-00014.
Villavicencio AT, Gray L, Leveque JC, Fukushima T, Kureshi S, Friedman AH. Utility of three-dimensional computed tomographic angiography for assessment of relationships between the vertebrobasilar system and the cranial base. Neurosurgery. 2001 Feb;48(2):318–26.
Villavicencio, A. T., et al. “Utility of three-dimensional computed tomographic angiography for assessment of relationships between the vertebrobasilar system and the cranial base.Neurosurgery, vol. 48, no. 2, Feb. 2001, pp. 318–26. Pubmed, doi:10.1097/00006123-200102000-00014.
Villavicencio AT, Gray L, Leveque JC, Fukushima T, Kureshi S, Friedman AH. Utility of three-dimensional computed tomographic angiography for assessment of relationships between the vertebrobasilar system and the cranial base. Neurosurgery. 2001 Feb;48(2):318–326.
Journal cover image

Published In

Neurosurgery

DOI

ISSN

0148-396X

Publication Date

February 2001

Volume

48

Issue

2

Start / End Page

318 / 326

Location

United States

Related Subject Headings

  • Vertebral Artery
  • Tomography, X-Ray Computed
  • Skull Base
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Intracranial Aneurysm
  • Imaging, Three-Dimensional
  • Humans
  • Female