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Neurovascular Surgical Techniques Pascal M Jabbour

1:Basic Arterial Anatomy of the Brain
- INTRODUCTION
- SUPRATENTORIAL ARTERIAL ANATOMY
  - Internal Carotid Artery
- INFRATENTORIAL ARTERIAL ANATOMY
2:Basic Venous Anatomy of the Brain
- INTRODUCTION
- VENOUS CATEGORIES
- CEREBRAL DIVISIONS
  - Superficial Venous Systems
  - Cortical and Anastomotic Veins
- SUPRATENTORIAL SINUSES
- POSTERIOR FOSSA AND SINUSES
  - Sinuses
  - Posterior Fossa Veins
- ANGIOGRAMS
- CONCLUSION
3:A Review of Microsurgical Instruments
- INTRODUCTION
- OPERATING MICROSCOPE
  - Operating Microscope Chair
- MECHANICS OF SURGICAL MICROINSTRUMENTS
  - Bayonetted Forceps
  - Microscissors
- MONOPOLAR AND BIPOLAR ELECTROCAUTERY
- SUCTION
- NEEDLE DRIVERS AND SUTURING MATERIAL
- DISSECTORS
- VASCULAR CLIPS AND CLIP APPLIERS
- CONCLUSION
4:A Review of Endovascular Tools
- HISTORY OF ENDOVASCULAR TREATMENTS
- LIQUID EMBOLIC AGENTS
5:Imaging Advances in Neurovascular Disease
- INTRODUCTION
- ACUTE ARTERIAL INFARCTION
- CERVICAL CAROTID STENOSIS
  - Carotid Dissection
  - Post Stent Follow-up
- EVALUATION OF SUBARACHNOID HEMORRHAGE
- ARTERIOVENOUS MALFORMATION AND DURAL ARTERIOVENOUS FISTULA
  - Dural Venous Sinus Thrombosis
  - Spinal Cord Arteriovenous Lesions
6:Microsurgical and Endovascular Treatment of Anterior Circulation Aneurysms
- NATURAL HISTORY, ANATOMY AND LITERATURE REGARDING ANTERIOR CIRCULATION ANEURYSMS
- COMMON THEME—ENDOVASCULAR OCCLUSION OF ANTERIOR CIRCULATION ANEURYSMS
- COMMON THEME—MICROSURGERY OF ANTERIOR CIRCULATION ANEURYSMS
  - Operative Procedure
  - Follow-Up
- PARACLINOID AND OPHTHALMIC ARTERY ANEURYSMS
- POSTERIOR COMMUNICATING ARTERY ANEURYSMS
  - Treatment
    - Endovascular
  - Key Points
    - Microsurgery
- ANTERIOR CHOROIDAL ARTERY ANEURYSMS
- INTERNAL CAROTID ARTERY TERMINUS ANEURYSMS
- MIDDLE CEREBRAL ARTERY ANEURYSMS
- PROXIMAL ANTERIOR CEREBRAL ARTERY, ANTERIOR COMMUNICATING ARTERY AND DISTAL ANTERIOR CEREBRAL ARTERY ANEURYSMS
  - Treatment
    - Endovascular
  - Key Points
    - Microsurgery
7:Microsurgical and Endovascular Treatment of Posterior Circulation Aneurysms
- INTRODUCTION
- OPEN SURGICAL MANAGEMENT
- ANCILLARY TECHNIQUES
- MICROSURGICAL VERSUS ENDOVASCULAR MANAGEMENT
- POSTERIOR CEREBRAL ARTERY ANEURYSMS
- SUPERIOR CEREBELLAR ARTERY ANEURYSMS
- ANTERIOR INFERIOR CEREBELLAR ARTERY ANEURYSMS
- POSTERIOR INFERIOR CEREBELLAR ARTERY ANEURYSMS
- VERTEBROBASILAR ANEURYSMS
- CONCLUSION
8:Microsurgical and Endovascular Treatment of Intracranial Giant Aneurysms
- INTRODUCTION
- EPIDEMIOLOGY AND NATURAL HISTORY
- PATHOPHYSIOLOGY
- CLINICAL FINDINGS
- IMAGING STUDIES
  - Balloon Test Occlusion
- MANAGEMENT
- ANTERIOR CIRCULATION GIANT ANEURYSMS
- ENDOVASCULAR MANAGEMENT OF INTRACRANIAL ANEURYSMS
- FOLLOW-UP OF GIANT ANEURYSMS AFTER TREATMENT
- CONCLUSION
- ACKNOWLEDGMENT
9:Liquid Embolic Agents in the Treatment of Intracranial Aneurysms
- INTRODUCTION
- ONYX LIQUID EMBOLIC AGENT
- OTHER LIQUID EMBOLIC AGENTS
- PATIENT SELECTION
- EMBOLIZATION TECHNIQUE
  - Postoperative Care
  - Case Illustrations
- DISCUSSION
  - Advantages
  - Disadvantages
- CONCLUSION
10:Biomechanics of Cerebral Aneurysms
- THE ROLE OF HEMODYNAMICS ON CEREBRAL ANEURYSM FORMATION, DEVELOPMENT, RUPTURE AND TREATMENT
  - Hemodynamic Factors
  - Other Hemodynamic Metrics and Descriptors
- TECHNIQUES FOR EVALUATING AND MEASURING ANEURYSM HEMODYNAMICS
- FACTORS THAT INFLUENCE CEREBRAL ANEURYSM HEMODYNAMICS
  - Aneurysm Geometric Features
    - Aneurysm Size Indices
    - Aneurysm Type: Sidewall and Bifurcating Aneurysms
  - Parent Vessel Geometry
- ENDOVASCULAR TREATMENT OF CEREBRAL ANEURYSMS
  - Embolic Coils
  - Endovascular Stents
11:Flow Diversion: New Paradigm for Cerebral Aneurysms
- INTRODUCTION
- PRELIMINARY EXPERIENCE WITH LOW POROSITY STENTS
- FLOW DIVERSION BIOLOGY
- CONCLUSION
12:Microsurgical and Endovascular Treatment of Brain Arteriovenous Malformations
- INTRODUCTION
- NATURAL HISTORY AND PRESENTATION
- PATIENT FACTORS
- PREOPERATIVE IMAGING
- ARTERIOVENOUS MALFORMATION GRADING
- NEUROANESTHESIA CONSIDERATIONS
- POSITIONING AND CRANIOTOMY
- SURGICAL TECHNIQUE
- POSTOPERATIVE MANAGEMENT
- SUPRATENTORIAL ARTERIOVENOUS MALFORMATIONS AND SURGICAL APPROACHES
- INFRATENTORIAL ARTERIOVENOUS MALFORMATIONS AND SURGICAL APPROACHES
- CONCLUSION
- INTRODUCTION
- TREATMENT STRATEGIES
- POSTEMBOLIZATION MANAGEMENT
- TIME TO RESECTION
- COMPLICATIONS
- CONCLUSION
13:Intracranial Occlusive Disease
- INTRODUCTION
- HISTORY
  - Atherosclerosis–Surgery
  - Atherosclerosis–Endovascular
- CEREBRAL REVASCULARIZATION IN MOYAMOYA DISEASE
- CONCLUSION
14:Extracranial Atherosclerosis
- INTRODUCTION
- SURGICAL TECHNIQUE
- CONCLUSION
- VERTEBRAL ARTERY DISEASE
- CONCLUSION
15:Acute Stroke Interventions
- BACKGROUND
- CONCLUSION
- CONCLUSION
- ABBREVIATIONS
16:Carotid-Cavernous Fistulas
- INTRODUCTION
- HISTORICAL OVERVIEW
- PATHOPHYSIOLOGY AND CLINICAL FEATURES
- TREATMENT
- RELEVANT VASCULAR ANATOMY
- CONCLUSION
- ACKNOWLEDGMENT
17:Cranial Arteriovenous Fistulae: Classifications, Endovascular and Surgical Techniques
- INTRODUCTION
- CLASSIFICATIONS OF CRANIAL DURAL ARTERIOVENOUS FISTULAE
- TREATMENT OPTIONS
- ENDOVASCULAR TECHNIQUES
  - Illustrative Cases of Different Endovascular Approaches
- SURGICAL TECHNIQUES
  - Illustrative Case: Surgical Disconnection of the Draining Vein
- COMBINED SURGICAL AND ENDOVASCULAR TECHNIQUES
  - Illustrative Case: Combined Endovascular and Surgical Approach for Sinus Sacrifice
- STEREOTACTIC RADIOSURGERY TECHNIQUES
18:Traumatic Vascular Injuries
- INTRODUCTION
- TRAUMATIC CEREBROVASCULAR INJURY: DEFINITION AND NATURAL HISTORY
  - Traumatic Aneurysms and Arteriovenous Fistula
  - Traumatic Vasospasm
- TRAUMATIC ANEURYSMS AND ARTERIOVENOUS FISTULA
- TRAUMATIC VASOSPASM
  - Case 1
  - Case 2
19:Spinal Arteriovenous Malformations
- INTRODUCTION
- CLASSIFICATION
- DIAGNOSTIC IMAGING
- MANAGEMENT THERAPY
20:Future Endovascular Technical Advances
- INTRODUCTION
- STROKE
- CAROTID ARTERY STENTING
- INTRACRANIAL ATHEROSCLEROSIS
- ANEURYSMS
  - Flow-Diverting Stents
  - Glues
- TUMORS
  - Embolization
  - Chemotherapeutics
- NEUROLOGICAL DISORDERS
- NEUROINTERVENTIONAL TRAINING: SIMULATORS/ROBOTICS/IMAGING
- CONCLUSION
21:Future Microsurgical Technical Advances
- REFLECTING ON HISTORY AND DIVINING THE FUTURE
- IMAGING, IMAGE GUIDANCE AND IMAGE FUSION TO GUIDE MICROSURGERY
- MINIMALLY INVASIVE AND ENDOSCOPICALLY ASSISTED NEUROSURGERY
- ROBOTICS IN NEUROSURGERY
- MICROINSTRUMENT DESIGN, ERGONOMICS AND THE OPERATING ROOM OF THE FUTURE
- PROCEDURES THAT WILL DIE, THOSE THAT WILL HAVE ANOTHER LIFE AND NOVEL MICROSURGICAL TASKS FOR THE FUTURE
- TRAINING CHALLENGES AND TEAM ASSEMBLY FOR FUTURE MICROSURGERY ADVANCES
22:Getting out of Trouble and Complication Avoidance in the Endovascular Techniques
- INTRODUCTION
- GENERAL GUIDELINES FOR COMPLICATION AVOIDANCE
- SELECTING THE ENDOVASCULAR PATIENT: RISK FACTORS AND PERIPROCEDURAL CARE
- RECOGNIZED PATIENT-RELATED RISK FACTORS
- PROCEDURAL RISK FACTORS
- ENDOVASCULAR PROCEDURAL COMPLICATIONS
  - Complications Common to All Interventional Procedures
  - Intervention-Specific Complications
- CONCLUSIONS: PEARLS FOR OPTIMAL PREPROCEDURAL PLANNING AND COMPLICATION AVOIDANCE
23:Getting out of Trouble and Complication Avoidance in Microsurgery
- INTRODUCTION
- THREE-DIMENSIONAL NEUROSURGICAL ANATOMY
- RESIDENCY AND FELLOWSHIP TRAINING
- INTRAOPERATIVE JUDGMENT
- CEREBRAL ANEURYSMS
- CEREBRAL ARTERIOVENOUS MALFORMATIONS
- INTRA-AXIAL TUMORS
- SKULL BASE TUMORS
24:Cavernous Malformation Surgery: Pearls and Pitfalls
- INTRODUCTION
- SUPRATENTORIAL SUPERFICIAL
- SUPRATENTORIAL DEEP
- BASAL GANGLIA
- THALAMUS AND PINEAL REGION
- CORPUS CALLOSUM, CINGULATE CORTEX AND VENTRICULAR SYSTEM
- INSULAR CORTEX
- INFRATENTORIAL
- CEREBELLUM AND CEREBELLAR PEDUNCLES
25:The Use of Intraoperative Cerebral Blood Flow Measurements in Neurosurgery: Past, Present, and Future
- INTRODUCTION
- TECHNIQUES FOR INTRAOPERATIVE QUANTIFICATION OF CEREBRAL BLOOD FLOW: THEORY, ADVANTAGES AND LIMITATIONS
- RADIONUCLIDE CLEARANCE
- PRESENT INTRAOPERATIVE APPLICATIONS: FLOW ASSISTED CEREBROVASCULAR SURGERY
  - Intraoperative Use for Primary Aneurysm Occlusion
    - Case Illustration
  - Intraoperative Use for Vessel Sacrifice and Cerebral Bypass
- CONCLUSION

INDEX

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Chapter Notes