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. 2020 Aug 3;88(1):82–95. doi: 10.1093/neuros/nyaa317

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© Congress of Neurological Surgeons 2020.

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FIGURE 5. — Imaging studies of another case of IPO. A 63-yr-old man presented with brainstem compression syndrome caused by BTVBJ-GFDA. He underwent the IPO with high-flow bypass (ECA-saphenous vein graft-PCA). A, Preoperative left vertebral angiogram revealing BTVBJ-GFDA. B, Preoperative T1-weighted MR image demonstrated significant brainstem compression by the aneurysm. C, Postoperative left vertebral artery angiograms showed disappearance of the BTVBJ-GFDA. D, An arrow is pointing at clips used for IPO. Postoperative right common carotid artery angiogram demonstrated patent ECA to PCA bypass. ECA, external carotid artery; PCA, posterior cerebral artery.