Facharzt FMH Neurochirurgie Practice Questions - Facharzt FMH Für Neurochirurgie Spécialiste FMH En Neurochirurgie Exam

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A 58-year-old woman is admitted with acute subarachnoid hemorrhage (WFNS Grade 1, Fisher Grade 2). Cerebral angiography reveals a 6 mm saccular basilar apex (bifurcation) aneurysm with a narrow neck pointing superiorly. The posterior cerebral arteries (P1 segments) originate cleanly below the aneurysm neck. Based on landmark randomized evidence from the International Subarachnoid Aneurysm Trial (ISAT) and posterior circulation anatomy, what is the preferred initial treatment modality?

Endovascular coil embolization Bifrontal craniotomy with transbasal subfrontal approach for surgical clipping Suboccipital telovelar approach for aneurysm trap ligation Conservative observation with blood pressure reduction to systolic <90 mmHg without intervention

Correct Answer:

Endovascular coil embolization

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