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…
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…
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…
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…
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…
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…
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….
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