Vein of Galen Malformations
Fig. 26.1 A choroidal vein of Galen aneurysmal malformation demonstrating the anterior nidal network of arterial feeders is shown by artist depiction (a) and after vertebral angiography (b). Fig. 26.2 A mural…
Pterional Craniotomy for Exposure of Contralateral Aneurysms
Patient Selection 21.2.1 Multiple Intracranial Aneurysms The majority of patients with multiple aneurysms harbor 2 aneurysms, although as many as 13 aneurysms have been described in a single patient. Approximately half…
Anterior Fossa, Superior Sagittal Sinus, and Convexity Dural Arteriovenous Malformations
Patient Selection 34.1.1 Indications Patients typically present with symptoms due to hemorrhage, ischemia, or hydrocephalus. They may also present with headache or a bruit, although bruits are less common than with…
Superficial Temporal Artery to Middle Cerebral Artery Bypass
Patient Selection The two main indications for extracranial to intracranial bypass are flow replacement for treatment of complex aneurysms or tumors, which requires vessel sacrifice, and flow augmentation for treatment…
Positional Compression of the Vertebral Arteries
Normal Anatomy, Sites of Compression, and Symptoms The vertebral artery (VA) is divided into four segments, termed V1–V4. The V1 or ostial segment arises from the subclavian artery and enters…
Pterional Transsylvian and Extended Approaches for Upper Basilar Aneurysms
Anatomy The basilar bifurcation is in the interpeduncular cistern. This location is bounded by the clivus and posterior clinoid processes anteriorly, the cerebral peduncles posteriorly, the mammillary bodies and posterior…
Intraventricular and Deep Arteriovenous Malformations
Patient Selection Choosing observation, microsurgical resection, focused irradiation, embolization, or some combination of these as the recommended management for deeply located arteriovenous malformations (AVMs) requires understanding of the risks and…
Superficial Cavernous Malformations
Keywords: cavernous malformation, craniotomy, vascular malformation 28.1 Patient Selection Typical computed tomographic (CT) characteristics of these lesions include focal or nodular appearing lesions with mild to moderate increase in attenuation without…
Anterior Communicating Artery Aneurysms
Anatomic Considerations The region of the anterior communicating artery (ACoA) has an extremely variable normal anatomy ( ▶ Fig. 8.1). The complex relationships between the blood vessels, aneurysm, and other…
Indirect Bypasses for Moyamoya Disease
Indirect Bypasses for Moyamoya Disease Edward Smith Abstract Moyamoya is a progressive intracranial arteriopathy with a high risk of stroke if left untreated. Surgical revascularization markedly reduces this risk, particularly…
