Abstract
Cerebral aneurysms of the anterior circulation include those that arise from the internal carotid artery (ICA) or any of its terminal branches. Although the indications for an endovascular approach to aneurysm treatment continue to expand, microsurgical treatment remains the preferred option for many patients with select anterior circulation aneurysms. The established durability, versatility, and effectiveness of microsurgical clip ligation for treating anterior circulation aneurysms set the standard by which all newer technologies must be judged. In this chapter, we provide a comprehensive review of the considerations necessary to effectively treat anterior circulation aneurysms microsurgically while avoiding common pitfalls (Table 13.1). In addition to reviewing the salient general preoperative and intraoperative matters of relevance to anterior circulation aneurysm surgery, we also discuss the specific considerations for aneurysms in each location.
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References
Todd NV, Howie JE, Miller JD. Norman Dott’s contribution to aneurysm surgery. J Neurol Neurosurg Psychiatry. 1990;53(6):455–8.
Kretzer RM, Coon AL, Tamargo RJ. Walter E. Dandy’s contributions to vascular neurosurgery. J Neurosurg. 2010;112(6):1182–91. https://doi.org/10.3171/2009.7.JNS09737.
Dandy WE. Intracranial aneurysm of the internal carotid artery: cured by operation. Ann Surg. 1938;107(5):654–9.
Tew JM Jr. M. Gazi Yasargil: neurosurgery’s man of the century. Neurosurgery. 1999;45(5):1010–4.
Lane B, Bohnstedt BN, Cohen-Gadol AA. A prospective comparative study of microscope-integrated intraoperative fluorescein and indocyanine videoangiography for clip ligation of complex cerebral aneurysms. J Neurosurg. 2015;122(3):618–26. https://doi.org/10.3171/2014.10.JNS132766.
Mack WJ, Ducruet AF, Angevine PD, Komotar RJ, Shrebnick DB, Edwards NM, Smith CR, Heyer EJ, Monyero L, Connolly ES Jr, Solomon RA. Deep hypothermic circulatory arrest for complex cerebral aneurysms: lessons learned. Neurosurgery. 2007;60(5):815–827.; Discussion 815–27. https://doi.org/10.1227/01.NEU.0000255452.20602.C9.
Ravussin P, de Tribolet N. Total intravenous anesthesia with propofol for burst suppression in cerebral aneurysm surgery: preliminary report of 42 patients. Neurosurgery. 1993;32(2):236–40. Discussion 240.
Mocco J, Komotar RJ, Raper DM, Kellner CP, Connolly ES, Solomon RA. The modified pterional keyhole craniotomy for open cerebrovascular surgery: a new workhorse? J Neurol Surg A Cent Eur Neurosurg. 2013;74(6):400–4. https://doi.org/10.1055/s-0032-1333130.
Wiebers DO, Whisnant JP, Huston J III, Meissner I, Brown RD Jr, Piepgras DG, Forbes GS, Thielen K, Nichols D, O’Fallon WM, Peacock J, Jaeger L, Kassell NF, Kongable-Beckman GL, Torner JC. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet. 2003;362(9378):103–10.
Elsharkawy A, Niemela M, Lehecka M, Lehto H, Jahromi BR, Goehre F, Kivisaari R, Hernesniemi J. Focused opening of the sylvian fissure for microsurgical management of MCA aneurysms. Acta Neurochir. 2014;156(1):17–25. https://doi.org/10.1007/s00701-013-1894-7.
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Ellis, J.A., Solomon, R.A., Connolly, E.S. (2018). Aneurysms of the Anterior Circulation. In: Gandhi, C., Prestigiacomo, C. (eds) Cerebrovascular and Endovascular Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-65206-1_13
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