Microsurgical clipping of true posterior communicating artery aneurysms

Abstract

Background: "True" posterior communicating artery (PCOM) aneurysms are rare variants in which the aneurysm arises solely from the PCOM rather than the junction of the internal carotid artery and the PCOM.

Methods: It is critical to note that for true PCOM aneurysms, the neck arises distal to the origin of the PCOM and therefore lies in what is traditionally an intra-operative blind spot. The PCOM must be followed posteriorly to visualise the aneurysm neck for microsurgical clipping.

Conclusions: A thorough pre-operative understanding of this unique anatomy is essential in minimising morbidity associated with microsurgical clipping of this aneurysm configuration.