Abstract
With the operating microscope, in the 1960s came a powerful, unobstructed light source and magnified anatomy. Shortly following this development, delicate and fine dissectors, forceps and scissors became available. Aneurysm clips were gradually modified to accommodate and make best use of this new technology. Direct microsurgical clipping by craniotomy has become the most commonly applied procedure for managing an intracranial aneurysm and is currently available to virtually every aneurysm surgeon. Because of the many variations in aneurysm size, shape, and location, and peculiarities in anatomy of accompanying vessels, each operation must remain highly individualized. This chapter describes those procedures that must be used to achieve a successful outcome in a patient harboring an intracranial aneurysm and the auxiliary therapy required to accomplish this to its best advantage.
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References
Traeger SM, Hemning RJ, Dobkin W, Gianotta S, Weirl MH, Weiss M. Hemodynamic effects of pentobarbital therapy for intracranial hypertension. Crit Care Med. 1983;11:697–701.
Cottrell JE, Robustelli A, Post K, Turndorf H. Furosemide and mannitol-induced changes in ICP and serum osmola-rity and electrolytes. Anesthesiology. 1977;47:28–30.
Dandy WE. Intracranial Arterial Aneurysms. New York: Comstock; 1944, reprinted 1969.
Kaplan HA. Results of obliteration of specific cerebral veins and dural venous sinuses: animal and human studies. In: Kapp JP, ed. The Cerebral Venous System and its Disorders. Boca Raton, FL: Grune and Stratton Inc; 1984:275–282.
Dujovny M, Kossovsky N, Perlin A, Segal R, Diaz F, Ausman JI. Intracranial clips: an examination of the devices used for aneurysm surgery. Neurosurgery. 1984; 14: 257–267.
Sugita K, Hirota T, Iguchi I, Mizutami T. Comparative study of the pressure of various aneurysm clips. J Neuro-surg. 1976;44:723–727.
Gertz SD, Renneis ML, Forbes MS, Kawamura J, Sunaga J, Nelson E. Endothelial cell damage by temporary arterial occlusion with surgical clips: study of the clip site by scanning and transmission electron microscopy. J Neuro-surg. 1976;45:514–519.
Symon L, Momma F, Murota T. Assessment of reversible cerebral ischemia in man: intraoperative monitoring of the somatosensory evoked response. Acta Neurochir (Wein). 1988;42:3–7.
Batjer H, Samson DS. Management of intraoperative aneurysm rupture. Clin Neurosurg. 1990;36:275–288.
Batjer HH, Samson DS. Retrograde suction decompression of giant paraclinoidal aneurysms. Technical note. J Neurosurg. 1990;73:305–306.
Pertuiset B. Intraoperative aneurysmal rupture and reduction by coagulation of the sac. In: Pia HW, Langmaid C, Zierski J, eds. Cerebral Aneurysms—Advances in Diagnosis and Therapy. Berlin: Springer-Verlag; 1979:398–401.
Karhunen PJ. Neurosurgical vascular complications associated with aneurysm clips evaluated by postmortem angiography. Forensic Sci Int. 1991;51:13–22.
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© 1994 Springer-Verlag New York, Inc.
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Smith, R.R., Zubkov, Y.N., Tarassoli, Y. (1994). Principles and Ergonomics of Direct Aneurysm Surgery. In: Cerebral Aneurysms. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-9532-4_6
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DOI: https://doi.org/10.1007/978-1-4613-9532-4_6
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4613-9534-8
Online ISBN: 978-1-4613-9532-4
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