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Changing Aspects in Stroke Surgery: Aneurysms, Dissections, Moyamoya Angiopathy and EC-IC Bypass pp 131–137Cite as

Historical landmarks in vascular Neurosurgery “On July 10th 2006, at the 70th Anniversary of the Department of Neurosurgery of Zürich Medical School”

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Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 103))

Abstract

Direct aneurysm surgery started more than 70 years ago. Introduction of cerebral angiography by Moniz in 20s and operating microscope by Yaşargil in 60s were the real cornerstones in vascular neurosurgery. Since then the development of neuroanestesiology and further development of non-invasive imaging (MRA and CTA) together with the latest development of operating microscopes with intraoperative ICG angio have shifted vascular microneurosurgery to a different level to still compete with the ‘non-invasiness’ of endovascular therapy. There is an increasing demand to perform the already forgotten bypasses mastered only by few and with the high-flow techniques (e.g. ELANA) we can treat lesions that some time ago were considered impossible. Endovascular embolization to reduce the flow in AVM before surgery is very helpful in those cases that can not be treated by embolization or radiosurgery alone.

We still need to find a way to detect aneurysms before they rupture and especially those thin-walled that are in an increased risk of rupture. Recent data on the pathobiology of the aneurysm wall may help us to better understanding of the growth mechanisms and it might be possible to develop more potent local or systemic pharmaceutical therapy to induce myo-intimal hyperplasia occluding the aneurysm and strengthening the wall to prevent rupture.

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Authors and Affiliations

  1. Department of Neurosurgery, Helsinki University Hospital, 00260, Helsinki, Finland

    Juha Hernesniemi M.D., Ph.D., R. Dashti, O. Mateo, P. Cancela, A. Karatas & M. Niemelä

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  1. Juha Hernesniemi M.D., Ph.D.
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  2. R. Dashti
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  3. O. Mateo
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  4. P. Cancela
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  5. A. Karatas
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  6. M. Niemelä
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Editor information

Editors and Affiliations

  1. Neurochirurgie FMH, Zurich, Switzerland

    Yasuhiro Yonekawa

  2. Department of Neurosurgery, Kyoto National Hospital, Kyoto, Japan

    Tetsuya Tsukahara

  3. Institut für Neuroradiologie, Universitätsspital Zurich, Zurich, Switzerland

    Anton Valavanis

  4. Neurochirurgische Klinik, Universitätsspital Zurich, Zurich, Switzerland

    Nadia Khan

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Hernesniemi, J., Dashti, R., Mateo, O., Cancela, P., Karatas, A., Niemelä, M. (2008). Historical landmarks in vascular Neurosurgery “On July 10th 2006, at the 70th Anniversary of the Department of Neurosurgery of Zürich Medical School”. In: Yonekawa, Y., Tsukahara, T., Valavanis, A., Khan, N. (eds) Changing Aspects in Stroke Surgery: Aneurysms, Dissections, Moyamoya Angiopathy and EC-IC Bypass. Acta Neurochirurgica Supplements, vol 103. Springer, Vienna. https://doi.org/10.1007/978-3-211-76589-0_24

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  • DOI: https://doi.org/10.1007/978-3-211-76589-0_24

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