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…
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…
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…
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…
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…
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…
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…
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 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…
Patient Selection 35.1.1 Carotid Stenosis The North American Symptomatic Carotid Endarterectomy Trial and the European Carotid Surgery Trial found that carotid endarterectomy (CEA) significantly decreased the incidence of ipsilateral stroke among…
