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Multiple aneurysm clipping, mean basilar bifurcation angle, and aneurysm neck distance from posterior clinoid process were shown to be factors that determine the surgical approach. Unfavorable outcome is strongly associated with poor Hunt-Hess grade on admission, distance from aneurysm neck (the posterior clinoid process), thrombosis, and dome size. Microsurgery for BBA clipping can be performed safely with simple surgical approaches subtemporal and LSO. There are several factors determining the approach selected. Poor patient outcome in