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This encyclopedic reference book on the treatment of intracranial aneurysms offers a case-based approach to the subject that has the benefit of fully reflecting the highly individual technical and clinical challenges encountered in aneurysm patients. The book is structured by aneurysm location, ensuring ease of use. Readers will find solutions for most clinical situations that they may encounter. Different treatment strategies are described, highlighting their respective pros and cons in particular circumstances. The coverage encompasses both basic techniques, such as coil occlusion and parent vessel occlusion, and the latest developments, including extra- and intrasaccular flow diversion, intrasaccular flow disruption, bifurcation stenting, and hybrid procedures combining microsurgical and endovascular elements. Potential procedural complications are identified, and bail-out strategies to anticipate, avoid, and solve major issues are described. The authors are all respected experts inthe field, and the book will be of value to vascular and endovascular neurosurgeons, interventional neuroradiologists and neurologists, stroke neurologists, and other practitioners at all levels of experience.

Documento del año 2019 en eltema Medicina - Neurología, psiquiatría, adicciones, Nota: 10, Universidad Europea de Madrid, Idioma: Español, Resumen: Hemorragia Subaracnoidea: La principal causa es el trauma. De las no traumáticas la causa más frecuente es la ruptura espontánea de aneurismas intracraneales. Representa del 70 al 90% de los casos. Los aneurismas suelen ser asintomáticos antes del sangrado. Se distribuyen en las grandes arterias, la mayoría en la circulación anterior (80-90%), más comúnmente en la unión de la arteria carótida interna con la arteria comunicante posterior, en la arteria comunicante anterior y en la trifurcación de la arteria cerebral media. El 10-20% restante se ubican en la circulación posterior, con frecuencia en la bifurcación de la arteria basilar. En un 10-20% de los casos se encuentran múltiples aneurismas. Otras más infrecuentes incluyen: Malformaciones arteriovenosas (MAV) Extensión de un sangrado intraparenquimatoso Hemorragia tumoral Aneurisma micótico Disección de arterias intracraneales Alteraciones de la coagulación Abuso de drogas (cocaína) Aneurismas y MAV medulares Vasculitis del sistema nervioso central. En un 10% de los casos existe un sangrado exclusiva o predominantemente perimesencefálico. Se denomina hemorragia subaracnoidea “perimesencefálica o pretroncal”. Su origen se desconoce, pero correspondería a un sangrado venoso. Se diferencia del resto por la regular negatividad en su estudio angiográfico, y por su buen pronóstico y buena evolución.

Intracranial aneurysm result from complex interactions between cerebrovascular anatomy, vascular injury, and adaptive remodeling of the arterial wall and represent a cerebrovascular disorder with the potential for substantial morbidity and mortality. Most intracranial aneurysms occur in the larger arteries near the skull base, in or around the circle of Willis, but variants may appear virtually anywhere in the cerebral vasculature. The aneurysm can leak or rupture, causing life-threatening bleeding, and is the most common cause of spontaneous subarachnoid hemorrhage, the third most common form of stroke. Intracranial aneurysms affect about 1 in 10,000 people per year in the United States (approximately 27,000). Intracranial Aneurysms will address the natural history, biology, and basic management principles and treatment of aneurysms. The chapters also explore the unique features of each type or location of aneurysm while considering the medical, surgical, and endovascular options. Contributions are by members of the Endovascular Neurosurgery Research Group, a group of recognized expert neurosurgeons who specialize in cerebrovascular and endovascular management of aneurysms. - Comprehensively covers the basic mechanisms, history, management and treatment of intracranial aneurysms - Written for researchers, residents and clinical practitioners in clinical neuroscience, neurology and neurosurgery - Contains contributions by expert neurosurgeons of the Endovascular Neurosurgery Research Group

Informações práticas e atuais não somente para o diagnóstico e tratamento dos aneurismas cerebrais, como também para a sua prevenção. Os últimos avanços e refinamentos tecnológicos vêm criando um novo paradigma para o diagnóstico e tratamento dos aneurismas cerebrais. Como a maioria dos aneurismas cerebrais torna-se sintomático somente com a ruptura e tem um comportamento imprevisível, o tratamento ainda se baseia na avaliação de riscos. Importantes desafios têm sido lançados com o desenvolvimento de novos dispositivos que atuam nas hemodinâmicas cerebral e aneurismática. Aneurismas Cerebrais vem contribuir com este novo cenário, fornecendo informações práticas e atuais não somente para o diagnóstico e tratamento dos aneurismas cerebrais, como também para a sua prevenção. Através de uma linguagem objetiva e simples, com uma abordagem prática e didática, esta obra interessa não apenas aos especialistas, mas a todo profissional da área que queira se aprofundar no assunto. A autora apresenta tanto sua experiência proveniente da pesquisa científica como dos anos de dedicação ao diagnóstico e tratamento de pacientes portadores de aneurismas cerebrais.

Anhand von 28 ausführlichen Fallbeispielen stellt dieses Buch das operative Vorgehen bei intrakraniellen Aneurysmen und Malformationen dar. Dabei wird ein breites Spektrum von Krankheitsformen, Lokalisationen und Eingriffen gezeigt. Zu jedem Fall werden die klinische Situation, die individuelle Anatomie und die Datenlage beschrieben; das therapeutische Vorgehen wird begründet und umfassend in Wort und zahlreichen Abbildungen geschildert, auch auf Risiken und mögliche Komplikationen gehen die Kapitel ein. Abgeschlossen wird jedes Fallbeispiel durch eine Analyse des gewählten Procedere und daraus abgeleiteten Empfehlungen für vergleichbare Konstellationen. Ausgewählte Falldarstellungen werden durch Videos ergänzt. Allgemeine Informationen zur anatomischen Variabilität zerebraler Gefäße, zu den chirurgischen und strahlentherapeutischen Behandlungsprinzipien, zur Pathologie und Klassifikation der einzelnen Erkrankungsgruppen sowie zur intraoperativen Diagnostik runden die Darstellung ab.

This atlas focuses on the imaging and treatment options available for giant intracranial aneurysms since 1990s in the beginning of the so-called modern endovascular era. During this period, there were significant advances made in the therapy of small intracranial aneurysms though the treatment of giant aneurysms continued to pose an insurmountable challenge. At the turn of this century, this grim scenario gradually improved with better understanding of the pathophysiology of giant intracranial aneurysms. This changed scenario in giant intracranial aneurysm therapy has been illustrated with the aid of informative clinical case studies. The clinical presentation of giant aneurysms in adults and children is described as are the merits of different imaging modalities explained and illustrated. Extensive consideration has been given to modern fusion imaging that has improved our insight into the nature of the disease. Endovascular treatment approaches (including illustrative open surgical approaches) and reconstructive and deconstructive strategies are fully documented, with careful attention given to factors that influence management strategies, treatment choice and complications.The atlas will be a valuable reference and practical aid for neuroradiologists, neurosurgeons, neurologists, fellowship trainees, postgraduate & graduate students.

This book describes the pathoanatomical, pathophysiological, and imaging features of vascular malformations and aneurysms of the brain and the modern, minimally invasive endovascular methods and techniques employed in their treatment. Individual chapters are devoted to developmental venous malformations, cavernomas and capillary telangiectasias, pial arteriovenous malformations, dural arteriovenous malformations, and intracranial aneurysms. Each chapter is subdivided into four principal sections on pathology, clinical presentation, diagnostic imaging, and therapy, ensuring a standardized approach throughout. All chapters in this 2nd revised edition of Intracranial Vascular Malformations and Aneurysms have been thoroughly updated. The book is richly illustrated with numerous informative CT, MR and DSA images, including high-end 7-Tesla MR images.