Spinal Vascular Malformations
Patient Selection Treatment of patients with spinal arteriovenous malformations (AVMs) carries a risk of paraplegia or quadriplegia. Therefore, before treatment is recommended, the natural history of the lesion must be…
Subtemporal and Pretemporal Approaches for Basilar and Posterior Cerebral Artery neurysms
Patient Selection Aneurysms at the distal third of the basilar artery including the basilar artery bifurcation and the origin of the superior cerebellar artery from the basilar artery and less…
Posterior Fossa Arteriovenous Malformations
Posterior fossa arteriovenous malformations (AVMs) comprise about 12% of all brain AVMs. About 70% present with hemorrhage into the brain parenchyma, the subarachnoid space, and/or the ventricular system. Current treatment…
Transsylvian Transclinoidal and Transcavernous Approach for Basilar Bifurcation Aneurysms
Patient Selection 14.1.1 Indications for Surgery and Alternatives Options for treatment of basilar apex region aneurysms include surgical clipping or endovascular treatment with coils. The preference for endovascular treatment tends to…
Arteriovenous Malformations of the Basal Ganglia and Thalamus
Patient Selection The overall risk of hemorrhage for cerebral arteriovenous malformations (AVMs) is about 2 to 4% per year. 1 Annual rupture rates are lower for unruptured AVMs compared to…
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…
