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Objective:The authors present the results of management outcomes for upper basilar artery aneurysms via transclinoidal approach. Methods:Clinical and angiographic evaluations were performed in twenty two consecutive patients with upper basilar artery aneurysms(three of them had superior cerebellar artery aneurysms) treated by surgery via transclinoidal approach between January, 1990 and April, 2000. Results:Of the 22 patients, fifteen patients had multiple aneurysms including basilar bifurcation aneurysms and basilar-superior cerebellar aneurysms. Seventy seven percent were in good preoperative neurological status(H-H grade I-III), 23% were in poor grade(H-H grade IV). The management outcome was:Glasgow outcome scale(GOS) I 54.5%, GOS II 18%, GOS III 13.6%, GOS IV 4.5% and GOS V(death) 9%. The major causes of morbidity were direct brain damage, perforator occlusion, vasospasm and meningitis. Conclusion:The management outcome of upper basilar artery aneurysms treated via clinoidectomy was good(72.5%). Transclinoidal approach is an acceptable alternative for upper basilar artery aneurysms. Key words:Upper basilar aneurysm;Clinoidectomy.