Skip to main content

The Current State of Aneurysm Microsurgery

  • Chapter
  • First Online:
  • 1117 Accesses

Abstract

The two burning questions regarding the management of cerebral aneurysms currently concern whether to use clip or coil and what to do with incidental aneurysms. Further issues that require continuing attention and research are primary and secondary damage following subarachnoid hemorrhage (i.e., delayed cerebral ischemia) and perhaps primary prevention of cerebral aneurysm formation by pharmaceutical treatment.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Molyneux AJ, Kerr RS, Birks J, Ramzi N, Yarnold J, Sneade M, et al. Risk of recurrent subarachnoid haemorrhage, death, or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the International Subarachnoid Aneurysm Trial (ISAT): long-term follow-up. Lancet Neurol. 2009;8:427–33.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Bailes JE, Spetzler RF, Hadley MN, Baldwin HZ. Management morbidity and mortality of poor-grade aneurysm patients. J Neurosurg. 1990;72:​559–66.

    Article  CAS  PubMed  Google Scholar 

  3. Vernooij MW, Ikram MA, Tanghe HL, Vincent AJ, Hofman A, Krestin GP, et al. Incidental findings on brain MRI in the general population. N Engl J Med. 2007;357:1821–8.

    Article  CAS  PubMed  Google Scholar 

  4. Greving JP, Wermer MJ, Brown Jr RD, Morita A, Juvela S, Yonekura M, et al. Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies. Lancet Neurol. 2014;13:​59–66.

    Article  PubMed  Google Scholar 

  5. Juvela S, Poussa K, Lehto H, Porras M. Natural history of unruptured intracranial aneurysms: a long-term follow-up study. Stroke. 2013;44:2414–21.

    Article  PubMed  Google Scholar 

  6. Kotowski M, Naggara O, Darsaut TE, Nolet S, Gevry G, Kouznetsov E, et al. Safety and occlusion rates of surgical treatment of unruptured intracranial aneurysms: a systematic review and meta-analysis of the literature from 1990 to 2011. J Neurol Neurosurg Psychiatry. 2013;84:42–8.

    Article  PubMed  Google Scholar 

  7. UCAS Japan Investigators, Morita A, Kirino T, Hashi K, Aoki N, Fukuhara S, et al. The natural course of unruptured cerebral aneurysms in a Japanese cohort. N Engl J Med. 2012;366:2474–82.

    Article  Google Scholar 

  8. Wiebers DO, Whisnant JP, Huston 3rd J, Meissner I, Brown Jr RD, Piepgras DG, et al.; International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet. 2003;362:103.

    Google Scholar 

  9. Brown Jr RD. Controversy: clipping of asymptomatic intracranial aneurysm that is <7 mm: yes or no? Stroke. 2013;44(6 Suppl 1):S96.

    Article  PubMed  Google Scholar 

  10. Steinberg GK. Controversy: clipping of asymptomatic intracranial aneurysm that is <7 mm: yes. Stroke. 2013;44(6 Suppl 1):S97–9.

    Article  PubMed  Google Scholar 

  11. Naggara ON, Lecler A, Oppenheim C, Meder JF, Raymond J. Endovascular treatment of intracranial unruptured aneurysms: a systematic review of the literature on safety with emphasis on subgroup analyses. Radiology. 2012;263:828–35.

    Article  PubMed  Google Scholar 

  12. Lovelock CE, Rinkel GJ, Rothwell PM. Time trends in outcome of subarachnoid hemorrhage: population-based study and systematic review. Neurology. 2010;74:​1494–501.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Béjot Y, Rouaud O, Durier J, Caillier M, Marie C, Freysz M, et al. Decrease in the stroke case fatality rates in a French population-based twenty-year study. A comparison between men and women. Cerebrovasc Dis. 2007;24:439–44.

    Article  PubMed  Google Scholar 

  14. Biotti D, Jacquin A, Boutarbouch M, Bousquet O, Durier J, Ben Salem D, et al. Trends in case-fatality rates in hospitalized nontraumatic subarachnoid hemorrhage: results of a population-based study in Dijon, France, from 1985 to 2006. Neurosurgery. 2010;66:​1039–43.

    Article  PubMed  Google Scholar 

  15. Beseoglu K, Holtkamp K, Steiger HJ, Hänggi D. Fatal aneurysmal subarachnoid haemorrhage: causes of 30-day in-hospital case fatalities in a large single-centre historical patient cohort. Clin Neurol Neurosurg. 2013;115:77–81.

    Article  PubMed  Google Scholar 

  16. Hussain I, Duffis EJ, Gandhi CD, Prestigiacomo CJ. Genome-wide association studies of intracranial aneurysms: an update. Stroke. 2013;44:2670–5.

    Article  PubMed  Google Scholar 

  17. Yasuno K, Bilguvar K, Bijlenga P, Low SK, Krischek B, Auburger G, et al. Genome-wide association study of intracranial aneurysm identifies three new risk loci. Nat Genet. 2010;42:420–5.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Steiger, HJ., Etminan, N., Hänggi, D. (2015). The Current State of Aneurysm Microsurgery. In: Microsurgical Brain Aneurysms. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45679-8_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-45679-8_1

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-45678-1

  • Online ISBN: 978-3-662-45679-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics