Giant Intracranial Aneurysms

Therapeutic Approaches

Inhaltsverzeichnis

Anatomical Definition.
Mechanisms of Formation: Pathologic Features.
Macroscopic Findings.
Microscopic and Ultrastructural Findings.
Natural History of Giant Intracranial Aneurysms.
Mechanisms of Formation: Hemodynamic Features.
Review of the Literature.
Model Experiments.
Clinical Study.
Incidence and Distribution.
Topographic Types.
Giant Intracranial Aneurysms in Childhood.
Neuroradiological Features.
Plain Skull Radiographs.
Angiography.
Computed Tomography.
Magnetic Resonance Imaging.
Radionuclide Brain Scanning.
Direct Surgical Treatment by Neck Occlusion.
General Technical Considerations.
Direct Surgical Approaches According to Topographic Type.
Direct Surgical Treatment by Wrapping and Intravascular Thrombosis.
Wrapping.
Intravascular Thrombosis.
Extracorporeal Circulation.
Surgical Occlusion of the Carotid Axis (Cervical Common Carotid Artery and Cervical Internal Carotid Artery).
Effects of Carotid Occlusion.
Carotid Artery Occlusion in Giant Aneurysms.
Surgical Occlusion of the Vertebrobasilar Axis (Vertebral Artery and Basilar Trunk).
Hemodynamic Effects of Occlusion in the Vertebrobasilar System.
Results in the Treatment of Giant Aneurysms.
Intracranial Occlusion of the Parent Artery.
Proximal Occlusion.
Trapping.
Tolerance of Occlusion.
Implantable Vascular Occluder.
Extra-intracranial Bypass.
Methods.
Patency.
Applications in Giant Aneurysms.
Tests for the Tolerance of Therapeutic Occlusion.
Selection of Patients.
Management by the Intravascular Approach.
Background.
Materials Used.
Clinical Experience and Therapeutic Indications.
General Conclusions.