Intracranial aneurysm result from complex interactions between cerebrovascular anatomy, vascular injury, and adaptive remodeling of the arterial wall and represent a cerebrovascular disorder with the potential for substantial morbidity and mortality. Most intracranial aneurysms occur in the larger arteries near the skull base, in or around the circle of Willis, but variants may appear virtually anywhere in the cerebral vasculature. The aneurysm can leak or rupture, causing life-threatening bleeding, and is the most common cause of spontaneous subarachnoid hemorrhage, the third most common form of stroke. Intracranial aneurysms affect about 1 in 10,000 people per year in the United States (approximately 27,000). Intracranial Aneurysms will address the natural history, biology, and basic management principles and treatment of aneurysms. The chapters also explore the unique features of each type or location of aneurysm while considering the medical, surgical, and endovascular options. Contributions are by members of the Endovascular Neurosurgery Research Group, a group of recognized expert neurosurgeons who specialize in cerebrovascular and endovascular management of aneurysms. - Comprehensively covers the basic mechanisms, history, management and treatment of intracranial aneurysms - Written for researchers, residents and clinical practitioners in clinical neuroscience, neurology and neurosurgery - Contains contributions by expert neurosurgeons of the Endovascular Neurosurgery Research Group

Professor Fox has undertaken the monumental In his Preface, Dr. Fox has quoted Cannon task of compiling the available data on intracra and Rosenblueth in questioning where to stop nial arterial aneurysms. The magnitude and ex the record. One can only document progress tent of the undertaking attest to the tremen to date-and certainly the advances in this field dous amount of information which has are noteworthy-and then make some cau accumulated in the past few decades and to tious predictions for the future. They have cor the accelerated pace at which the field has ex rectly made note that the overall morbidity panded, particularly since the end of World and mortality of these aneurysm patients re War II. mains unacceptably high, largely as a result of Our heritage can be traced to many sources, the secondary complications of the subarach among whom should be mentioned such nota noid hemorrhage itself. More attention should bles as Willis, Quincke, Blackall, Moniz, Dott, be directed in the future to the recognition of Dandy, Hounsfield, and others. The modern era those patients with unruptured aneurysms and includes a number of investigators and clini those with minimal bleeds. Hopefully infor cians, some of whom have contributed to this mation will be forthcoming as to which indi magnificent tome. The bibliography of over viduals are at risk because of some unusual con 4000 references represents the increasing in genital, metabolic, or acquired defect.

The first aneurysms explored by such pioneers of neurosurgery as Cushing and Dandy were the giant intracranial aneurysms. These giant aneurysms present many therapeutic difficulties and, because of their unique anatomical features and size, may present in a multitude of ways. With the advent of specialized imaging techniques such as computed tomography (CT), mag netic resonance imaging (MRI) and selective angiography, preoperative diag nosis today is most often accomplished without difficulty. However, com pletely thrombosed giant aneurysms may mimic other lesions with mass effect (such as basilar meningiomas, chordomas or chondromas) and their true anatomical shapes and relations to other cranial structures can only be ascer tained by direct operative inspection. Due to their morphological features (thrombosed, nonthrombosed, par tially thrombosed, fusiform), anatomical variations and difficult locations, giant aneurysms present new challenges for the modern neurosurgeon. Al though microsurgical techniques have rendered direct surgical treatment of giant intracranial aneurysms safer, elimination of the aneurysm without dis turbing the hemodynamics continues to be problematic. Some of these lesions have relatively small necks and can therefore be clipped fairly easily. Others have large necks, are fusiform, or contain perforators; how best to treat these lesions is a question still unresolved by presentday neurosurgery.

This atlas focuses on the imaging and treatment options available for giant intracranial aneurysms since 1990s in the beginning of the so-called modern endovascular era. During this period, there were significant advances made in the therapy of small intracranial aneurysms though the treatment of giant aneurysms continued to pose an insurmountable challenge. At the turn of this century, this grim scenario gradually improved with better understanding of the pathophysiology of giant intracranial aneurysms. This changed scenario in giant intracranial aneurysm therapy has been illustrated with the aid of informative clinical case studies. The clinical presentation of giant aneurysms in adults and children is described as are the merits of different imaging modalities explained and illustrated. Extensive consideration has been given to modern fusion imaging that has improved our insight into the nature of the disease. Endovascular treatment approaches (including illustrative open surgical approaches) and reconstructive and deconstructive strategies are fully documented, with careful attention given to factors that influence management strategies, treatment choice and complications.The atlas will be a valuable reference and practical aid for neuroradiologists, neurosurgeons, neurologists, fellowship trainees, postgraduate & graduate students.

Microsurgery has brought about important changes and progress in the treatment of cere bral aneurysms in recent years. Only 12 years ago McKissock, one of the most experienced surgeons in the treatment of aneurysms pompared the results of operative and nonoperative treatment. He found that mortality and morbidity of cerebral aneurysms was not significantly affected by whether the patients have been operated upon or not. This view is held by many neursurgeons, and was confirmed by results of the Co-operative Study in 1969. In the review on treatment of aneurysms in Progress in Neurological Surgery in 1969, techniques such as encasement with plastic compounds, piloinjection, stereotactic copper or electric thrombosis and metallic thrombosis and profound hypothermia in anaesthesia were listed. In general, these techniques now seem to be of little more than historical interest. Progress in recent yeats has been so enormous that one may perhaps gain the impreSSion that the main problems in the treatment of aneurysms have been solved and that there are no more to be surmounted. This is dangerous and complacent thinking, such as Lord Moynihan indulged in during the thirties. For this reason we thought that the time had come to assemble a group of experts who could discuss the various unsolved and contro versial problems of aneurysm surgery in the friendly and relaxed atmosphere of a "work shop".

Current Management of Cerebral Aneurysms reviews the pathophysiology, clinical presentation, and the medical and surgical management of cerebral aneurysms by discussing the clinical and radiological diagnosis, perioperative management of ruptured aneurysms. Topics covered in Current Management of Cerebral Aneurysms include: The epidemiology, genetics, and clinical behavior of intracranial aneurysms Imaging of cerebral aneurysms Perioperative management of ruptured aneurysms Anesthetic management Surgical treatment of anterior circulation aneurysms Detection, prevention and management of cerebral vasospasm (Distributed by Thieme for the American Association of Neurological Surgeons)

This book provides recent progress of neuroendovascular surgery, which is a minimally invasive treatment of cerebral aneurysms. Great advances have been made in the techniques, devices and large randomized clinical trials showing striking therapeutic benefit for cerebral aneurysms. The treatment of cerebral aneurysms has also seen substantial evolution, increasing the number of aneurysms that can be treated successfully with minimally invasive therapy. In the 17 chapters, authors introduce the techniques, devices, device structures and therapeutic concepts. Attendings, fellows, residents, medical students or anyone interested in sharpening their diagnostic and therapeutic skill set will benefit from reading this text. This book will include many clinical cases and skills and clinical concepts, which will benefit professional /practitioner.

This book constitutes the First Cerebral Aneurysm Detection Challenge, CADA 2020, which was held in conjunction with the 23rd International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2020, in October 2020. The conference was planned to take place in Lima, Peru, and took place virtually due to the COVID-19 pandemic. The 9 regular papers presented in this volume, together with an overview and one introduction paper, were carefully reviewed and selected for inclusion in the book. The papers were organized in topical sections as follows: cerebral aneurysm detection; cerebral aneurysm segmentation; and cerebral aneurysm rupture risk estimation.

Surgical repair of cerebral aneurysms is a core aspect of neurosurgical practice. While open microvascular technique has dominated Western surgical practice, surgeons in the former USSR have developed endovascular techniques that have gained acceptance among surgeons here. This text demonstrates both surgical and endovascular approaches, written and illustrated by surgeons with vast experience in both, in a comparative context. The work is extensively illustrated with full-color surgical illustrations, line drawings, and radiographs.