Transclival decompression of brainstem from a compressing coiled aneurysm of the midbasilar artery.

The authors present the case of a young woman, suffering from progressive tetraplegia, cranial nerve dysfunction, respiratory failure and lethargy due to radiographically demonstrated increased brainstem compression after coil embolization of an aneurysm of the midportion of the basilar artery. The patients condition improved dramatically after transclival decompression. The importance of understanding the effects of a rigid endovascular mass on adjacent neural structures is emphasized.