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Chapter-08 Microsurgical and Endovascular Treatment of Intracranial Giant Aneurysms

BOOK TITLE: Neurovascular Surgical Techniques

Author
1. Gupta Gaurav
2. Singh Rahul K
3. Shukla Pratik A
4. Liu James K
5. Duffis Jesus
6. Gandhi Chirag D
7. Prestigiacomo Charles J
ISBN
9789350900888
DOI
10.5005/jp/books/11824_8
Edition
1/e
Publishing Year
2013
Pages
17
Author Affiliations
1. PGIMER, Chandigarh, e-mail: drgauravpeds@yahoo.com, Robertwood Johnson Medical School, University of Medicine and Dentistry of New Jersey, CAB-2100, New Brunswick, New Jersey, USA, Jaipur Dental College, Jaipur, Rajasthan India
2. Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
3. Neurological Institue of New Jersey, New Jersey Medical School 90 Bergen Street, Suite 8100, Newark, New Jersey, USA
4. Neurological Institue of New Jersey, New Jersey Medical School 90 Bergen Street, Suite 8100, Newark, New Jersey, USA
5. New Jersey Medical School, 90 Bergen Street, Suite 8100, Newark, New Jersey, USA
6. Neurological Institute of New Jersey, New Jersey Medical School, 90 Bergen St, Suite 8100, Newark, New Jersey, USA
7. New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA
Chapter keywords
Intracranial giant aneurysms, saccular, fusiform, serpentine, subarachnoid hemorrhage, microneurosurgical treatment

Abstract

There are three types of giant aneurysms namely saccular, fusiform, and serpentine. A 10% of all giant aneurysms occur in children. Endovascular technique being a primary treatment of giant aneurysms is also used as an adjunctive treatment to open neurosurgical techniques. The primary goal of endovascular therapy is to prevent subarachnoid hemorrhage (SAH), occlude the giant aneurysm directly and to exclude them from cerebral circulation. Giant aneurysms treated by endovascular techniques require a follow-up of at least a 5-year period. The open microneurosurgical treatment has been the treatment of choice for giant intracranial aneurysms. These include either direct options (direct aneurysm clipping) or indirect options (parent vessel ligation or takedown). The treatment of giant aneurysms is a multi-modality approach and the choice of open microsurgical versus endovascular treatment is based on individual aneurysm characteristics. The chapter in detail discusses about the natural history, epidemiology, pathophysiology, clinical findings, imaging and certain follow-up require after the treatment of intracranial giant aneurysms.

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