Brainstem Cavernous Malformations
Epidemiology Cavernous malformations (CMs) constitute 5 to 13% of all vascular lesions in the brain and spinal cord. 1 With advanced imaging techniques, the detection rate, and therefore the incidence,…
Minimally Invasive Approaches for Spontaneous Intracerebral Hemorrhage
Minimally Invasive Approaches for Spontaneous Intracerebral Hemorrhage Jennifer Kosty, Norberto Andaluz, Chiraz Chaalala, and Mario Zuccarello Abstract Minimally invasive surgical (MIS) evacuation of intracerebral hemorrhage effectively reduces clot burden with…
Infectious Intracranial Aneurysms
Patient Selection 22.1.1 Diagnosis Clinical suspicion for an infectious intracranial aneurysm should be raised in a patient with bacterial endocarditis and acute onset of neurological symptoms. 1, 2 The presumed pathophysiology…
Distal Anterior Cerebral Artery Aneurysms: Anterior Interhemispheric Approach
Clinical Presentation and Diagnostic Workup In the same manner as with aneurysms in other locations, distal anterior cerebral artery (DACA) aneurysms may present symptomatically with subarachnoid hemorrhage (SAH) or may…
Arteriovenous Malformations of the Cerebral Convexities
Preoperative Planning 23.1.1 Patient Selection All arteriovenous malformation (AVM) therapies should be directed toward prevention of hemorrhage, neurologic decline, epilepsy, and death. As a general rule, the AVM must be completely…
Endoscopic Approaches to Intracranial Aneurysms
The most important step in applying the endoscope to aneurysm surgery is the design of a small, short, lightweight scope and camera ( ▶ Fig. 19.1). The Storz Image 1…
Minimally Invasive Approaches to Aneurysms
Patient Selection The minimally invasive approach for aneurysms means small and strategically placed craniotomies ( ▶ Fig. 5.1), avoiding brain retraction and minimizing tissue damage during dissection. Acceptable minimally invasive…
Vertebral Artery and Posterior Inferior Cerebellar Artery Aneurysms
Anatomical Features and Patient Selection The posterior inferior cerebellar artery (PICA) has a highly variable origin: in 90% of individuals, it originates from the so-called intradural V4 segment of the…
Vascular and Microsurgical Instrumentation and Equipment
Operating Microscope The microscope serves two main functions—magnification and illumination—permitting smaller exposures, improved visibility for dissection of delicate tissues, and safer hemostasis when working through narrow and deep surgical corridors….
