Indications Cavernous malformations are angiographically occult vascular malformations that typically come to clinical attention because of seizures or acute hemorrhage. With widespread use of noninvasive imaging, many cavernous malformations are now being diagnosed incidentally. Surgery is recommended in symptomatic patients…
Additional videos for this topic are available online at . Indications General Indications for Treatment of Dural Arteriovenous Fistulas The indication for treatment of cranial dural arteriovenous fistulas (DAVFs) is dictated by their natural history. Because the risk of…
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Indications Basilar apex aneurysms include ruptured or unruptured basilar bifurcation aneurysms, superior cerebellar artery (SCA) aneurysms, and proximal posterior cerebral artery (PCA) aneurysms. Patients who are young and have good clinical grades (Hunt and Hess grades I to III), broad…
Indications Ruptured aneurysms of the vertebral artery, vertebrobasilar junction, and proximal posterior inferior cerebellar artery (PICA) that are not favorable for endovascular treatment should be considered for surgery. Unruptured aneurysms of the vertebral artery, vertebrobasilar junction, and PICA that are…
Additional videos for this topic are available online at . Indications Distal anterior cerebral artery (DACA) aneurysms are usually small with a relatively broad base, are distally located, and have one or more branches originating from their base. These…
Indications We prefer surgical clipping of most ruptured and unruptured middle cerebral artery (MCA) aneurysms because of the accessibility of their location and the relatively low morbidity and durability of clipping compared with endovascular therapy. The exception is in patients…
Additional videos for this topic are available online at . Indications for Craniotomy Ruptured Aneurysm All paraclinoid aneurysms presenting with subarachnoid hemorrhage that are unfavorable for endovascular treatment. Paraclinoid ruptured aneurysms with Hunt and Hess grade I, II, or…
Indications Absolute Subarachnoid hemorrhage with intraparenchymal hemorrhage requiring emergent evacuation Subarachnoid hemorrhage with posterior communicating artery (Pcomm) aneurysm not repairable using endovascular techniques Strong Aneurysm presenting with symptoms referable to mass effect, classically presenting as ophthalmoplegia caused by direct compression…