Cerebral Aneurysms

1 History of Aneurysm Surgery.- 2 Morphology and Aetiology.- 2.1 Pathology and Aetiology of Intracranial Aneurysms.- 2.2 Factors Related to Growth, Rupture and Spontaneous Healing of Cerebral Aneurysms.- 2.3 Origin, Rupture and Growth of Cerebral Aneurysms: a Clinicopathological Study.- 2.4 Discussion.- 3 Classification.- 3.1 Introduction.- 3.2 Extracranial Internal Carotid Aneurysms.- 3.2.1 Aneurysms of the Cervical Internal Carotid Artery.- 3.2.2 Internal Carotid Aneurysms Arising in the Carotid Canal.- 3.2.3 Anatomy of the Cavernous Sinus.- 3.2.4 Intracavernous Carotid Aneurysm Jean Brihaye, Brussels.- 3.2.5 Aneurysms of the “Cavernous Sinus”.- 3.2.6 Discussion.- 3.3 Intracranial Internal Carotid Artery Aneurysms.- 3.3.1 Internal Carotid Ophthalmic Aneurysms.- 3.3.2 Aneurysms of the Internal Carotid (ICA) Ophthalmic Artery (OA) Junction.- 3.3.3 Aneurysms of the Internal Carotid Artery (ICA) and Posterior Communicating Artery (PCoA) and Anterior Choroidal Artery (AChA) Region.- 3.3.4 Internal Carotid Artery Bifurcation Aneurysms.- 3.3.5 Aneurysms of Internal Carotid Artery Bifurcation.- 3.3.6 Discussion.- 3.4 Aneurysms of the Anterior Cerebral Artery.- 3.5 Aneurysms of the Middle Cerebral Artery.- 3.5.1 Aneurysms of the Middle Cerebral Artery — Discussion.- 3.6 Aneurysms of the Vertebral Artery.- 3.7 Aneurysms of the Basilar Artery.- 3.8 Aneurysms of the Posterior Cerebral Artery.- 4 Distribution of Cerebral Aneurysms.- 5 Clinical Pathology and Pathophysiology.- 5.1 Noninvasive Regional Cerebral Blood Flow Measurement in Subarachnoid Haemorrhage.- 5.2 Cerebral Blood Flow in Subarachnoid Haemorrhage.- 5.3 Subarachnoid Haemorrhage and Cerebral Vasospasm.- 5.4 Cerebral Vasospasm: Prediction, Prevention and Protection.- 5.5 Hydrocephalus Following Subarachnoid Haemorrhage.- 5.6 Discussion.- 6 Neuroradiological Diagnosis.- 6.1 Cerebral Angiography.- 6.1.1 Classical Angiography.- 6.1.2 Magnification and Tomography.- 6.1.3 Intraoperative Angiography.- 6.1.4 Discussion.- 6.2 Computer Tomography.- 6.2.1 CAT Findings in Cerebral Aneurysms and Subarachnoid Haemorrhage.- 6.2.2 Value of CAT in Pre- and Postoperative Management of Cerebral Aneurysms.- 6.2.3 Discussion.- 7 Conservative Treatment.- 7.1 Preoperative Treatment of Intracranial Aneurysms.- 7.2 Preoperative Management of Ruptured Intracranial Aneurysms with Antifibrinolytic Treatment.- 7.3 Discussion.- 8 Operative Treatment.- 8.1 General Therapeutic Problems.- 8.1.1 Grading and Timing of the Operation on Cerebral Aneurysms.- 8.1.2 Indication and Timing of Operation and Vasospasm.- 8.1.3 Discussion.- 8.1.4 Deliberate Hypotension with Sodium Nitroprusside in Neuroanesthesia.- 8.1.5 Protective Vascular Mechanisms of the Brain During Profound Arterial Hypotension.- 8.1.6 Discussion.- 8.2 Special Therapeutic Problems.- 8.2.1 Internal Carotid Artery Aneurysms — Cavernous Sinus Aneurysms.- 8.2.1.1 Surgical Approach to Cavernous Sinus Aneurysms.- 8.2.1.2 Treatment of Carotid-Cavernous Fistulae and Arterial Aneurysms by Detachable Balloon.- 8.2.1.3 Post-traumatic Fistulae Between the Internal Carotid Artery and the Cavernous Sinus.- 8.2.1.4 Discussion.- 8.2.2 Internal Carotid Ophthalmic Artery Aneurysms.- 8.2.2.1 Treatment and Results for Carotid Ophthalmic Aneurysms.- 8.2.2.2 Discussion.- 8.2.3 Internal Carotid Posterior Communicating Anterior Choroidal Region Aneurysms.- 8.2.3.1 Microsurgical Treatment.- 8.2.3.2 Technical Aspects.- 8.2.4 Internal Carotid Artery Bifurcation Aneurysms.- 8.2.4.1 Special Therapeutic Problems.- 8.2.5 Anterior Cerebral Artery Aneurysms.- 8.2.5.1 Operative Treatment.- 8.2.5.2 Discussion.- 8.2.6 Middle Cerebral Artery Aneurysms.- 8.2.6.1 Treatment of Saccular Aneurysms.- 8.2.7 Addendum: Classification of Vertebrobasilar Aneurysms.- 8.2.8 Vertebral Artery Aneurysms.- 8.2.8.1 Operative Treatment.- 8.2.9 Basilar Artery Aneurysms.- 8.2.9.1 Surgery.- 8.2.9.2 Surgery of Upper Basilar Artery Aneurysms. Experience with 11 Cases.- 8.2.9.3 Microsurgical Treatment of Vertebrobasilar Aneurysms.- 8.2.9.4 Transoral-Transclival Approach.- 8.2.9.5 Discussion.- 8.2.10 Posterior Cerebral Artery Aneurysms.- 8.2.10.1 Operative Treatment.- 8.3 Giant Cerebral Aneurysms.- 8.3.1 Problems in Treatment.- 8.3.2 Discussion.- 8.3.2.1 Management.- 8.3.2.2 Results.- 8.3.2.3 Serpiginious Giant Aneurysm of the Internal Carotid Artery in a Young Female.- 8.3.2.4 General Discussion.- 8.4 Multiple Aneurysms.- 8.4.1 Treatment.- 8.4.2 Discussion.- 8.5 Traumatic Aneurysms.- 8.5.1 Survey.- 8.5.2 Development of Traumatic True Saccular Aneurysms.- 8.6 Aneurysms of Childhood.- 8.7 Special Technical Problems.- 8.7.1 Surgery of Intracranial Aneurysms — To Clip or not to Clip the Neck of the Sac.- 8.7.2 Slipping Clip.- 8.7.3 Form of Clips.- 8.7.4 Coagulation of Aneurysms.- 8.7.5 Discussion.- 8.7.6 Temporary Clipping — Prolongation of the Time of Occlusion by Mannitol.- 8.7.7 Trapping Techniques.- 8.7.8 Wrapping Technique — Present Place.- 8.7.8.1 Discussion.- 8.7.9 Cervical Carotid Artery Ligation.- 8.7.9.1 Discussion.- 8.8 Operative Treatment of Complications.- 8.8.1 Intraoperative Aneurysmal Rupture and Reduction by Coagulation of the Sac.- 8.8.1.1 Discussion.- 8.8.2 Intracerebral Haematomas.- 8.8.2.1 Discussion.- 9 Prognosis of Operative Treatment.- 9.1 A 25 Year Study.- 9.2 Summary.- 9.3 Discussion.- 9.3.1 Prognosis of 1000 Pure Saccular Aneurysms Operated Upon.- 9.3.2 Results and Discussion.- 9.3.3 Statistics of La Pitié Material.- 9.3.4 Results.- 9.3.5 Personal Experiences.- 9.3.6 Material of Institute of Neurology, London.- 10 Final Comments.- 11 References.- 12 Subject Index.