Surgical treatment of posterior circulation aneurysms is more difficult than surgical treatment of anterior circulation aneurysms and poses a greater technical challenge for the practicing neurosurgeon. There are different surgical options available for the surgical treatment of posterior circulation aneurysms despite the use of the pterional approach to anterior circulation aneurysms. We present our surgical experiences with three cases of posterior circulation aneurysms. Three cases of posterior circulation aneurysms were treated by surgical clipping. We preferred pterional approach for posterior cerebral artery aneurysms, infratentorial supracerebellar approach for superior cerebellar aneurysm, and the combined lateral supracerebellar infratentorial retrosigmoid approach for vertebrobasilar junction aneurysm. The morbidity and mortality associated with open surgery for posterior circulation aneurysms are higher because of the location of the aneurysms within the posterior fossa. For neurosurgeons, the surgical treatment of posterior circulation aneurysms can be challenging.

Keywords: Aneurysm, infratentorial supracerebellar approach, pterional approach, posterior circulation, retrosigmoid approach