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…
Carotid Endarterectomy
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…
Tentorial and Posterior Fossa Dural Arteriovenous Fistulas
Tentorial and Posterior Fossa Dural Arteriovenous Fistulas Tyler S. Cole, Martin J. Rutkowski, Peter Nakaji, and Michael T. Lawton Abstract Dural arteriovenous fistulas (DAVFs) are abnormal connections between an artery…
Fusiform, Dolichoectatic, and Dissecting Aneurysms
Fusiform and Dolichoectatic Aneurysms Fusiform or dolichoectatic aneurysms cause symptoms in three ways: compression, ischemia, or rupture. Compared with saccular aneurysms, dolichoectatic aneurysms are more likely to cause compression or…
Carotid Cavernous Fistulas
Carotid cavernous fistulas (CCFs) are abnormal arteriovenous shunts between the internal carotid artery (ICA) and the cavernous sinus either via direct connection with the ICA and/or its intracavernous branches or…
