Neurosurgical Management of Aneurysmal Subarachnoid Haemorrhage


Book Description

The small neck of the aneurysm afforded an easy surgical attack. An ordinary flat silver clip was placed over the sac and tightly compressed obliterated it completely. The clip was flush with the wall of the carotid artery. The sac, lateral to the silver clip, was then picked up with the forceps and thrombosed by the electocautery. Walter Dandy reporting his successful operation of a posterior communicating aneurysm on March 23, 1937. Walter Dandy's patient left the hospital in good health 2 weeks later, and from his report one may gain the impression that the operation was an easy task. Despite continuous developments during the following decades, it was not until the introduction of the operating microscope and microsurgical techniques that surgical treatment was generally accepted. During the microsurgical era surgical results have continued to improve due to diagnostical, neuroanaesthesi ological, and microsurgical refinements, and improved neurointensive care. Endovascular obliteration has become an important treatment alternative but this has not been included in this particular volume. The purpose of the present supplement of the ACTA NEUROCHIRURGICA is to review some of the elements in the neurosurgical management of patients with aneurysmal subarachnoid haemorrhage that are important for a successful outcome. Professor Helge Nornes has been a major force in the development of new techniques and research strategies in this area for a number of years and has recently retired from the National Hospital in Oslo.







Giant Intracranial Aneurysms


Book Description

This atlas focuses on the imaging and treatment options available for giant intracranial aneurysms since 1990s in the beginning of the so-called modern endovascular era. During this period, there were significant advances made in the therapy of small intracranial aneurysms though the treatment of giant aneurysms continued to pose an insurmountable challenge. At the turn of this century, this grim scenario gradually improved with better understanding of the pathophysiology of giant intracranial aneurysms. This changed scenario in giant intracranial aneurysm therapy has been illustrated with the aid of informative clinical case studies. The clinical presentation of giant aneurysms in adults and children is described as are the merits of different imaging modalities explained and illustrated. Extensive consideration has been given to modern fusion imaging that has improved our insight into the nature of the disease. Endovascular treatment approaches (including illustrative open surgical approaches) and reconstructive and deconstructive strategies are fully documented, with careful attention given to factors that influence management strategies, treatment choice and complications.The atlas will be a valuable reference and practical aid for neuroradiologists, neurosurgeons, neurologists, fellowship trainees, postgraduate & graduate students.




Trends in Cerebrovascular Surgery


Book Description

This volume provides an overview of new concepts in neurovascular interventions based on clinical and scientific knowledge of cerebrovascular disorders. It especially focuses on subarachnoid hemorrhage and cerebrovascular malformations, e.g. aneurysms, arterio-venous malformations, and cavernomas. A separate part addresses cerebral revascularization for both complex aneurysms and ischemia. All contributions were written by recognized experts and cover original papers presented at the 7th European Japanese Stroke Surgery Conference, held in Verona, Italy in June 2014. The authors present new trends and strategies for managing emerging problems, as well as in-depth discussions on controversial issues in the field.




Neurovascular Surgery


Book Description

This open access book presents the diagnosis, investigation and treatment of neurovascular diseases, and offers expert opinions and advice on avoiding complications in neurovascular surgery. It also covers complication management and post-operative follow-up care. The book is divided in to three parts; the first part discusses common approaches in neurovascular surgery, describing the steps, indications for and limitations of the approach, as well as the associated complications and how to avoid them. The second part addresses surgical treatment based on pathology, taking the different locations of lesions into consideration. The third part focuses on the technological developments that support neurovascular surgery, which may not be available everywhere, but have been included to help vascular surgeon understand the principles. This book is a guide for young neurosurgeons, neurosurgery residents and neurosurgery fellows, as well as for medical students and nurses who are interested in neurosurgery or are associated with this field in any way. It is also a useful teaching aid for senior neurosurgeons.




Surgery of Vertebrobasilar Aneurysms


Book Description

It is a great privilege to write the foreword for this classical work of Professor Charles Drake. There is no doubt that intracranial aneurysms have existed since the beginning of time. This terrifying disease of the brain arteries, with its dramatic consequences for the patient, has surely been observed in all human collectives, although clear definition and description in the literature began only 300 years ago. During the last century, clinical signs and symptoms have been carefully observed and analyzed, and 100 years ago, the first attempts were made for surgical treatment, such as the ligature of external and internal carotid and vertebral arteries. With the introduction of angiography, an entirely new dimension of diagnosis and differential diagnosis of the vascular diseases of CNS, was accomplished. In the years between 1945 and 1970, the neurosurgeon was increasingly stimulated to directly eliminate intracranial aneurysms. The most respected and avoided location, the aneurysms at the bifurcation of the basilar artery, remained as a "dark corner. " Several pioneers of neurosurgery attempted to explore the interpeduncular fossa, but finally retreated. Not so Charles Drake. His vision must have been stronger than his anxiety, after experiences of initial fatalities, to persevere more decisively in this desperate fight instead of to yield. Such steadfastness requires enormous courage. But what distin guishes courage! Surgical courage is not just a fearless or unscrupulous action.




Uncommon Causes of Stroke


Book Description

An essential resource for diagnosis and treatment of stroke patients outside the usual clinical categories.




Cerebral Aneurysms


Book Description

Surgical repair of cerebral aneurysms is a core aspect of neurosurgical practice. While open microvascular technique has dominated Western surgical practice, surgeons in the former USSR have developed endovascular techniques that have gained acceptance among surgeons here. This text demonstrates both surgical and endovascular approaches, written and illustrated by surgeons with vast experience in both, in a comparative context. The work is extensively illustrated with full-color surgical illustrations, line drawings, and radiographs.




Management of Cerebral Aneurysms


Book Description

Two top neurosurgeons deliver complete, up-to-date guidance on the diagnosis and management of cerebrovascular aneurysms and malformations in this groundbreaking new resource. Stressing a multidisciplinary, team approach, this text presents a wealth of information on the treatment of aneurysms, the management of subarachnoid hemorrhage, techniques to occlude aneurysms*both surgical and endovascular*patient selection, and more.




Endovascular Treatment of Intracranial Aneurysms


Book Description

A comprehensive review of current endovascular techniques for the treatment of cerebral aneurysms, this is a practical manual for those practicing, or intending to practice, this rapidly expanding branch of minimally invasive surgery. The authors provide descriptions based on an extensive combined experience of clinical management, technical problems, complications and recent results, and discuss the limitations and role of combined extravasular/endovascular techniques.