Assessment of the Endoscopic Endonasal Transclival Approach for Surgical Clipping of Anterior Pontine AICA Aneurysms

Highlights • Surgical exposure of the lesions of the anterior region of the brainstem is problematic due to the proximity of neurovascular structures and deep location. • Subtemporal anterior petrosectomy and presigmoid craniotomy are usually used to gain surgical access to the anterior pontine region. • Exposure of the aneurysms of the proximal AICA is suboptimal with current surgical techniques. • Endoscopic endonasal approaches are evolving as a surgical possibility for treatment of selected aneurysms. • In the current anatomical study, endoscopic endonasal transclival approach was found to be a viable option for treatment of the lesions of the proximal AICA.