Intracranial Aneurysms

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

Researchers, clinical practitioners, and residents in clinical neuroscience, neurology, and neurosurgery

1. Background – i.e. biology, development, risk factors?
   a. Vascular Development / Embryology
   b. Biology of Aneurysm formation
   c. Risk factors for aneurysm formation
   d. Experimental Aneurysm Models
   2. Evaluation and Management of Aneurysms and SAH
   a. Imaging for intracranial aneurysms
   b. Indications and benefits of surveillance for intracranial aneurysms
   c. Indications and benefits of screening for intracranial aneurysms
   d. Workup of SAH
   e. Natural history and evaluation of SAH of unknown cause
   f. Medical and ICU management of SAH
   g. Vasospasm: physiology, prevention and management
   3. Surgical techniques
   a. Technical principles of aneurysm clipping
   b. Anesthetic techniques
   c. Indications and technique for bypass
   d. Neurophysiological monitoring
   e. Parent artery sacrifice
   f. Complication avoidance and management
   4. Endovascular techniques
   a. Diagnostic angiography techniques and complication avoidance
   b. Endovascular devices
   c. Anticoagulation and antiplatelets
   d. Endovascular techniques: direct coil, balloon assist, stent assist
   e. Endovascular flow diversion
   f. Balloon test occlusion
   g. Parent artery sacrifice
   h. Complication avoidance and management
   5. Specifics of aneurysm treatment (each chp/section will discuss specifics of endo and surg treatment)
   a. Anterior communicating artery
   b. Internal carotid aneurysms
   i. Carotid cave and paraclinoid
   ii. Communicating segment (PComm/A Chor)
   iii. Carotid terminus
   c. Middle cerebral artery
   d. Vertebral artery/PICA
   e. Basilar artery
   i. Trunk aneurysms / AICA
   ii. Basilar terminus
   iii. PCA / SCA
   f. Pericallosal
   g. Distal aneurysms
   6. Atypical aneurysms –
   a. dissections,
   b. fusiform aneurysms,
   c. mycotic,
   d. traumatic