Surgical Management of Posterior Circulation Aneurysms: Defining the Role of Microsurgery in Contemporary Endovascular Era

In the period between 1930 and 1960, surgical treatment of posterior circulation aneurysms were only possible by indirect trapping or parent vessel ligation. Olivecrona was said to have performed the first unplanned trapping of a posterior inferior cerebellar artery (PICA) aneurysm in 1932. In 1937, Tonnis inadvertently opened a cerebellopontine angle aneurysm having assumed that it was a tumour preoperatively1. Dandy performed the first vertebral artery ligation beneath the atlas to treat a vertebral aneurysm in 1944 2. In 1948, Schwartz3 reported his experience with direct surgical approach to a large basilar artery aneurysm and successfully trapped it using silver clips. Logue4 and Mount5 formally described the techniques of vertebral artery and basilar artery ligation in 1958 and 1962, respectively.