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It is a great privilege to write the foreword for this classical work of Professor Charles Drake. There is no doubt that intracranial aneurysms have existed since the beginning of time. This terrifying disease of the brain arteries, with its dramatic consequences for the patient, has surely been observed in all human collectives, although clear definition and description in the literature began only 300 years ago. During the last century, clinical signs and symptoms have been carefully observed and analyzed, and 100 years ago, the first attempts were made for surgical treatment, such as the ligature of external and internal carotid and vertebral arteries. With the introduction of angiography, an entirely new dimension of diagnosis and differential diagnosis of the vascular diseases of CNS, was accomplished. In the years between 1945 and 1970, the neurosurgeon was increasingly stimulated to directly eliminate intracranial aneurysms. The most respected and avoided location, the aneurysms at the bifurcation of the basilar artery, remained as a "dark corner. " Several pioneers of neurosurgery attempted to explore the interpeduncular fossa, but finally retreated. Not so Charles Drake. His vision must have been stronger than his anxiety, after experiences of initial fatalities, to persevere more decisively in this desperate fight instead of to yield. Such steadfastness requires enormous courage. But what distin guishes courage! Surgical courage is not just a fearless or unscrupulous action.
This open access book presents the diagnosis, investigation and treatment of neurovascular diseases, and offers expert opinions and advice on avoiding complications in neurovascular surgery. It also covers complication management and post-operative follow-up care. The book is divided in to three parts; the first part discusses common approaches in neurovascular surgery, describing the steps, indications for and limitations of the approach, as well as the associated complications and how to avoid them. The second part addresses surgical treatment based on pathology, taking the different locations of lesions into consideration. The third part focuses on the technological developments that support neurovascular surgery, which may not be available everywhere, but have been included to help vascular surgeon understand the principles. This book is a guide for young neurosurgeons, neurosurgery residents and neurosurgery fellows, as well as for medical students and nurses who are interested in neurosurgery or are associated with this field in any way. It is also a useful teaching aid for senior neurosurgeons.
The art of aneurysm microsurgery in a beautifully illustrated, step-by-step volume Finalist in 2012 IBPA Benjamin Franklin Awards Seven Aneurysms: Tenets and Techniques for Clipping combines the instructive nature of a textbook with the visual aspects of an atlas to guide readers through the surgical principles, approaches, and techniques they need to dissect and clip cerebral aneurysms. Comprised of three concise sections, the book distills the distinguished author's vast experience into a series of easily accessible tutorials presented through clear, systematic descriptions and stunning, full-color illustrations. The first section explains the critical concepts and basic tenets of aneurysm microsurgery followed by a section on the various craniotomies and exposures necessary for successful clipping. The final section covers microsurgical anatomy, dissection strategies, and clipping techniques for each of the seven most common aneurysm types that are the focus of this book. Features: Strategies for handling the seven aneurysms most often seen by neurosurgeons: PCoA, MCA, ACoA, OphA, PcaA, basilar bifurcation, and PICA 383 full-color surgical photographs demonstrate operative techniques; 77 high-quality drawings display anatomy and spatial relationships Succinct text facilitates quick reading and easy reference Clipping remains an essential treatment method for the most frequently encountered aneurysms. This must-have guide will enable neurosurgery residents, fellows, or practicing neurosurgeons to handle the majority of the aneurysms they will encounter with confidence and poise.
A comprehensive review of vascular disease in the vertebrobasilar circulation by one of the world's leading authorities, fully updated throughout.
The small neck of the aneurysm afforded an easy surgical attack. An ordinary flat silver clip was placed over the sac and tightly compressed obliterated it completely. The clip was flush with the wall of the carotid artery. The sac, lateral to the silver clip, was then picked up with the forceps and thrombosed by the electocautery. Walter Dandy reporting his successful operation of a posterior communicating aneurysm on March 23, 1937. Walter Dandy's patient left the hospital in good health 2 weeks later, and from his report one may gain the impression that the operation was an easy task. Despite continuous developments during the following decades, it was not until the introduction of the operating microscope and microsurgical techniques that surgical treatment was generally accepted. During the microsurgical era surgical results have continued to improve due to diagnostical, neuroanaesthesi ological, and microsurgical refinements, and improved neurointensive care. Endovascular obliteration has become an important treatment alternative but this has not been included in this particular volume. The purpose of the present supplement of the ACTA NEUROCHIRURGICA is to review some of the elements in the neurosurgical management of patients with aneurysmal subarachnoid haemorrhage that are important for a successful outcome. Professor Helge Nornes has been a major force in the development of new techniques and research strategies in this area for a number of years and has recently retired from the National Hospital in Oslo.
Neurointervention is a fast-growing subspecialty, and recent trials have demonstrated its role in ischaemic and haemorrhagic stroke. This has generated tremendous interest among interventional neuroradiology, neurology and neurosurgery communities. Nevertheless, formal teaching programmes that provide the required experience are limited, and many early career practitioners are not exposed to the crucial technical details essential to safely performing the procedure before they start practising independently. The book presents 100 characteristic case studies to illustrate the salient technical and clinical issues in decision-making and problem solving during the procedure. This book conveys the “real-world” issues and solutions that are not addressed in detail in most books. As such it is a practical teaching book with useful “tips and tricks” on how to handle specific challenging situations, and is particularly useful for fellows in neurointervention training programmes..
An essential resource for diagnosis and treatment of stroke patients outside the usual clinical categories.
Vascular malformations of the brain and spine pose many management challenges. This text provides a comprehensive, state-of-the-art review of the natural history, treatment options, and outcomes of patients with these conditions. Despite their relative rarity, these lesions are responsible for devastating injury to individuals and can cause an enduring physical, psychological, and economic burden on patients and families. Many new therapeutic options are now available with the advent of novel surgical, endovascular, and radiosurgical techniques. The basic sciences have fuelled development of small molecule and biologic therapies targeting the molecular basis of disease. Authored by international experts in the fields of neurosurgery, neurology, radiology, and radiation oncology, this book provides state-of-the-art treatment plans and discussions of ideal therapy. This text is aimed at practitioners in the fields of neurology, neurosurgery, neuroradiology, radiation oncology, rehabilitation medicine and allied fields who care for patients with brain and spinal vascular malformations.
This encyclopedic reference book on the treatment of intracranial aneurysms offers a case-based approach to the subject that has the benefit of fully reflecting the highly individual technical and clinical challenges encountered in aneurysm patients. The book is structured by aneurysm location, ensuring ease of use. Readers will find solutions for most clinical situations that they may encounter. Different treatment strategies are described, highlighting their respective pros and cons in particular circumstances. The coverage encompasses both basic techniques, such as coil occlusion and parent vessel occlusion, and the latest developments, including extra- and intrasaccular flow diversion, intrasaccular flow disruption, bifurcation stenting, and hybrid procedures combining microsurgical and endovascular elements. Potential procedural complications are identified, and bail-out strategies to anticipate, avoid, and solve major issues are described. The authors are all respected experts in the field, and the book will be of value to vascular and endovascular neurosurgeons, interventional neuroradiologists and neurologists, stroke neurologists, and other practitioners at all levels of experience.