Indications • Symptomatic intracerebral hemorrhage (ICH) causing progressive neurologic symptoms or impending cerebral herniation syndromes is best managed with open evacuation, especially in younger patients, in whom there is less…
Indications • Eloquently located ruptured arteriovenous malformation (AVM) with significant hematoma and neurologic deficit • Angioarchitectural features that deem the cortical AVM at higher risk of hemorrhage (e.g., deep venous…
Indications • Ruptured or unruptured aneurysms of the vertebral artery, vertebrobasilar junction, and proximal posterior inferior cerebellar artery (PICA) have a particularly high rerupture rate and morbidity and mortality if…
Indications • Basilar apex aneurysms include ruptured or unruptured basilar bifurcation aneurysms, superior cerebellar artery (SCA) aneurysms, and P1 posterior cerebral artery (PCA) aneurysms. • Patients who are young and…
Indications Ruptured Aneurysm • All ruptured paraclinoid aneurysms with subarachnoid hemorrhage as the presentation need to be treated. Multiple and bilateral aneurysms are more common among this group of aneurysms….
Indications • Clipping of distal anterior cerebral artery (DACA) aneurysms has a long-lasting effect; rerupture of previously clipped aneurysm is very rare. • DACA aneurysms are usually small, with a…
Indications • We prefer surgical clipping of most ruptured and unruptured middle cerebral artery (MCA) aneurysms because of the accessibility of their location and the relatively low morbidity and durability…
Indications Absolute • Subarachnoid hemorrhage with intraparenchymal hemorrhage requiring emergent evacuation • Subarachnoid hemorrhage with anterior communicating artery (Acomm) aneurysm not repairable by endovascular coiling Strong • Large aneurysm (≥10…
Indications Absolute • Subarachnoid hemorrhage with intraparenchymal hemorrhage requiring emergent evacuation • Subarachnoid hemorrhage with posterior communicating artery (Pcomm) aneurysm not repairable by endovascular coiling Strong • Large aneurysm (≥10…
Indications • The retrolabyrinthine approach is a hearing-preserving presigmoid approach that uses a mastoidectomy and skeletonization of the sigmoid sinus to expose the presigmoid dura behind the semicircular canals. •…
