{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T18:47:14Z","timestamp":1767034034331},"reference-count":29,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,8]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> The authors report on the surgical results they achieved in caring for patients with vertebral artery\u2014posterior inferior cerebellar artery (VA\u2014PICA) saccular aneurysms that were treated via either the transcondylar fossa (supracondylar transjugular tubercle) approach or the transcondylar approach. In this report they clarify the characteristics of and differences between these two lateral skull base approaches. They also present the techniques they used in performing the transcondylar fossa approach, especially the maneuver used to remove the jugular tubercle extradurally without injuring the atlantooccipital joint.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> Eight patients underwent surgery for VA\u2014PICA saccular aneurysms (six ruptured and two unruptured ones) during which one of the two approaches was performed. Clinical data including neurological and radiological findings and reports of the operative procedures were analyzed. The Glasgow Outcome Scale was used to estimate the activities of daily living experienced by the patients.<\/jats:p>\n<jats:p content-type=\"fine-print\">In all cases the aneurysm was successfully clipped and no permanent neurological deficits remained, except for one case of severe vasospasm. In seven of the eight patients, the transcondylar fossa approach provided a sufficient operative field for clipping the aneurysm without difficulty. In the remaining patient, in whom the aneurysm was located at the midline on the clivus at the level of the hypoglossal canal, the aneurysm could not be found by using the transcondylar fossa approach; thus, the route was changed to the transcondylar approach, and clipping was performed below the hypoglossal nerve rootlets.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> Both approaches offer excellent visualization and a wide working field, with ready access to the lesion. This remarkably reduces the risk of development of postoperative deficits. These approaches should be used properly: the transcondylar fossa approach is indicated for aneurysms located above the hypoglossal canal and the transcondylar approach is indicated for those located below it.<\/jats:p>","DOI":"10.3171\/jns.2001.95.2.0268","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T17:35:08Z","timestamp":1242236108000},"page":"268-274","source":"Crossref","is-referenced-by-count":61,"title":["Surgery on a saccular vertebral artery\u2014posterior inferior cerebellar artery aneurysm via the transcondylar fossa (supracondylar transjugular tubercle) approach or the transcondylar approach: surgical results and indications for using two different lateral skull base approaches"],"prefix":"10.3171","volume":"95","author":[{"given":"Toshio","family":"Matsushima","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichiro","family":"Matsukado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiro","family":"Natori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanori","family":"Inamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsutomu","family":"Hitotsumatsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Fukui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1007\/BF02750998","article-title":"The effect of condylectomy on extreme lateral transcondylar approach to the anterior foramen magnum.","volume":"139","author":"A\u00e7ikbas","year":"1997"},{"key":"b2","series-title":"Neurosurgery","first-page":"987","article-title":"Clinical analysis of a series of vertebral aneurysm cases.","volume":"31","author":"Andoh","year":"1992"},{"key":"b3","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1227\/00006123-199112000-00002","article-title":"The dorsolateral, suboccipital, transcondylar approach to the lower clivus and anterior portion of the craniocervical junction.","volume":"29","author":"Bertalanffy","year":"1991"},{"key":"b4","series-title":"Neurol Med Chir","doi-asserted-by":"publisher","first-page":"93","DOI":"10.2176\/nmc.38.suppl_93","article-title":"Management of aneurysms of the vertebral artery-posterior inferior cerebellar artery complex.","volume":"38","author":"Bertalanffy","year":"1998"},{"key":"b5","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/0090-3019(85)90042-4","article-title":"Microsurgical anatomy of the region of the foramen magnum.","volume":"24","author":"de Oliveira","year":"1985"},{"key":"b6","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1016\/S0090-3019(97)00378-9","article-title":"The supracondylar approach to the jugular tubercle and hypoglossal canal.","volume":"50","author":"Gilsbach","year":"1998"},{"key":"b7","series-title":"Neurosurgery, Update II: Vascular, Spinal, Pediatric, and Functional Neurosurgery.","first-page":"2357","article-title":"The far lateral inferior suboccipital approach","author":"Heros","year":"1991"},{"key":"b8","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"559","DOI":"10.3171\/jns.1986.64.4.0559","article-title":"Lateral suboccipital approach for vertebral and vertebrobasilar artery lesions.","volume":"64","author":"Heros","year":"1986"},{"key":"b9","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1097\/00006123-199811000-00012","article-title":"Posteroinferior cerebellar artery aneurysms: surgical results for 38 patients.","volume":"43","author":"Horowitz","year":"1998"},{"key":"b10","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"381","DOI":"10.3171\/jns.1983.58.3.0381","article-title":"Aneurysms of the posterior inferior cerebellar artery. A clinical and anatomical analysis.","volume":"58","author":"Hudgins","year":"1983"},{"key":"b11","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"14","DOI":"10.3171\/jns.1968.28.1.0014","article-title":"Surgical risk as related to time of intervention in the repair of intracranial aneurysms.","volume":"28","author":"Hunt","year":"1968"},{"key":"b12","series-title":"Lancet","first-page":"480","article-title":"Assessment of outcome after severe brain damage. A practical scale.","volume":"1","author":"Jennett","year":"1975"},{"key":"b13","series-title":"Surg Cereb Stroke","doi-asserted-by":"publisher","first-page":"263","DOI":"10.2335\/scs1987.21.4_263","article-title":"[Difference of surgical field between the lateral suboccipital approach and the transcondylar approach for the midline vertebral aneurysms.]","volume":"21","author":"Kawase","year":"1993"},{"key":"b14","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/0090-3019(89)90316-9","article-title":"Surgical repair of aneurysms of the posterior inferior cerebellar artery\u2014a clinical series.","volume":"31","author":"Lee","year":"1989"},{"key":"b15","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1097\/00006123-198202000-00004","article-title":"Microsurgical anatomy of the posterior inferior cerebellar artery.","volume":"10","author":"Lister","year":"1982"},{"key":"b16","series-title":"Neurosurg Lett","first-page":"815","article-title":"[Design in the bony opening for lateral approaches to the foramen magnum\u2014posterior condylar emissary vein as an intraoperative anatomical mark.]","volume":"4","author":"Matsushima","year":"1994"},{"key":"b17","series-title":"Neurol Surg","first-page":"119","article-title":"[Lateral approaches to the foramen magnum: with special reference to the transcondylar fossa approach and transcondylar approach.]","volume":"24","author":"Matsushima","year":"1996"},{"key":"b18","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1007\/s007010070005","article-title":"Surgical treatment of glossopharyngeal neuralgia as vascular compression syndrome via transcondylar fossa (supracondylar transjugular tubercle) approach.","volume":"142","author":"Matsushima","year":"2000"},{"key":"b19","series-title":"Surgical Anatomy for Microneurosurgery VII.","first-page":"81","article-title":"[Microsurgical anatomy for lateral approaches to the foramen magnum\u2014with special reference to the far lateral approach and the transcondylar approach]","author":"Matsushima","year":"1995"},{"key":"b20","series-title":"Brain Tumor Surgery\u2014Its Standard Technique and New Design.","first-page":"206","article-title":"Surgery of the foramen magnum meningiomas\u2014special reference to the approaches based on their anatomical relationship to the vertebral artery","author":"Matsushima","year":"2000"},{"key":"b21","series-title":"Skull Base Surg","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1055\/s-2008-1058570","article-title":"Microsurgical anatomy for lateral approaches to the foramen magnum with special reference to transcondylar fossa (supracondylar transjugular tubercle) approach.","volume":"8","author":"Matsushima","year":"1998"},{"key":"b22","series-title":"Surg Cereb Stroke","doi-asserted-by":"publisher","first-page":"265","DOI":"10.2335\/scs1987.25.4_265","article-title":"[Clipping of a VA\u2014PICA aneurysm near the midline through transcondylar fossa approach (supracondylar transjugular tubercle approach).]","volume":"25","author":"Matsushima","year":"1997"},{"key":"b23","series-title":"Surg Cereb Stroke","doi-asserted-by":"publisher","first-page":"59","DOI":"10.2335\/scs1987.27.1_59","article-title":"[Clipping of a midline VA\u2014PICA aneurysm through transcondylar approach: location of the aneurysm and surgical approach.]","volume":"27","author":"Matsushima","year":"1999"},{"key":"b24","series-title":"Surgery In and Around the Brain Stem and the Third Ventricle: Anatomy, Pathology, Neurophysiology, Diagnosis, Treatment.","first-page":"460","article-title":"The posterolateral approach to the foramen magnum","author":"Perneczky","year":"1986"},{"key":"b25","series-title":"J Neurosurg","first-page":"206","article-title":"Variations of the extreme-lateral craniocervical approach-anatomical study and clinical analysis of 69 patients.","volume":"90","author":"Salas","year":"1999"},{"key":"b26","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1227\/00006123-199007000-00002","article-title":"Aneurysms of the posterior inferior cerebellar artery\u2014vertebral artery complex: variations on a theme.","volume":"27","author":"Salcman","year":"1990"},{"key":"b27","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1227\/00006123-199008000-00004","article-title":"An extreme lateral approach to intradural lesions of the cervical spine and foramen magnum.","volume":"27","author":"Sen","year":"1990"},{"key":"b28","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"555","DOI":"10.3171\/jns.1997.87.4.0555","article-title":"Microsurgical anatomy of the transcondylar, supracondylar, and paracondylar extensions of the far-lateral approach.","volume":"87","author":"Wen","year":"1997"},{"key":"b29","series-title":"No Shinkei Geka","first-page":"705","article-title":"[Differences between transcondylar approach and retroauricular transpetrosal transtentorial approach for midline vertebrobasilar aneurysms.]","volume":"22","author":"Yamamoto","year":"1994"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/95\/2\/article-p268.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/95\/2\/article-p268.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/95\/2\/article-p268.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T20:55:40Z","timestamp":1679864140000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/95\/2\/article-p268.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,8]]},"references-count":29,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/jns.2001.95.2.0268","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[2001,8]]}}}