ABSTRACT
The success of treating basilar aneurysms lies in the preservation of all perforating arteries and best selection of the surgical approaches. The purpose of this study was to define the microsurgical anatomy of the basilar artery and surgical approaches to the basilar artery. The microsurgical anatomy of the basilar artery and its branches were evaluated in adult cadaveric brains using 3x to 20x magnification. The branches of the basilar artery can be divided into three main groups: the cerebellar, lateral pontine, and perforating arteries. The lateral pontine arteries arise from the basilar trunk and course laterally to the brachium pontis. The perforating arteries originated from the basilar trunk and penetrating near the midline of the pons on its basal surface. The basilar trunk was approached via subtemporal-transtentorial, anterior transpetrosal, posterior transpetrosal and transchondylar routes. Selection of approach for basilar aneurysms was discussed.