Clinical Pearls Stroke has been one of the leading causes of mortality and serious long-term disability. Timely treatment of patients with acute ischemic stroke can drastically change the outcomes. Endovascular treatment has become an important treatment modality for acute ischemic…
Clinical Pearls Hemorrhagic stroke accounts for 10% of all strokes. Strokes are the third leading cause of death and the main cause of long-term disability in the United States. Spontaneous intracerebral hemorrhage (ICH) is most commonly caused by chronic hypertension…
Clinical Pearls Cerebral cavernous malformations (CCMs) are vascular lesions that contain a compact bundle of pathologic capillary vessels without intervening brain parenchyma. CCMs are relatively common, affecting approximately 1 in every 200 individuals and accounting for 8% to 15% of…
Clinical Pearls Cerebral arteriovenous malformations (AVMs) are high-flow, high-pressure vascular anomalies that cause neurologic morbidity, resulting in seizures, ischemic or steal symptoms, or hemorrhage. Cerebral AVMs are classified on the basis of treatment risk, including nidus size, location within eloquent…
Clinical Pearls Cerebral revascularization is a critical tool used to treat complex cerebral aneurysms. Careful preoperative planning and selection of the donor, recipient, and graft vessels are key to a successful outcome. Appropriate selection of low-flow or high-flow bypass is…
Clinical Pearls Superior cerebellar artery aneurysms are often favorable for clipping because they tend to project laterally off of the midline, which places them directly in the well-visualized carotid-oculomotor triangle. They are associated with less morbidity than basilar apex aneurysms…
Clinical Pearls Although endovascular intervention is an important part of the treatment of aneurysms, expertise and proficiency in open surgical management of cerebral aneurysms are essential requirements. Each aneurysm location requires its own unique set of nuances and methods, which…
Clinical Pearls The incidence of intracranial aneurysms is variable throughout the world and is approximately 6% in the international population, with higher rates in Asian/Finnish populations and those with a high-risk profile. In patients without any risk factors, the incidence…
Clinical Pearls Normal cerebral autoregulation maintains stable cerebral blood flow over a range of systemic perfusion pressures and metabolic demands. Atherosclerosis is an inflammatory disease characterized by the progressive deposition of atheromatous plaques that narrow affected arteries. The prevalence of…
Clinical Pearls Treatment decision making for arteriovenous malformations should take into account the lifetime risk associated with the aggressive natural history of these lesions. Whenever surgically feasible (specifically for grades I through III lesions), microsurgical resection with multimodality therapy (endovascular…