Introduction The clinical manifestations of supratentorial stroke, ischemic or hemorrhagic, are usually diagnosed in a timely fashion. However, infratentorial stroke can be indolent, and its diagnosis is often delayed until severe clinical symptoms are evident. The posterior fossa tolerates very…
Epidemiology Hemorrhagic infarction, or intracerebral hemorrhages (ICHs), make up approximately 14% of all strokes. Within the United States, ICH occurs with an incidence estimated to range from 15 to 35 cases per 100,000 people per 1 year. Each year, approximately…
Subarachnoid hemorrhage, when caused by the rupture of an intracranial aneurysm, has a mortality rate near 50% at 30 days, and approximately half of the survivors sustain irreversible brain damage. To avoid such a catastrophic event, it is important to…
Introduction Cervicocerebral arterial dissection is an important cause of stroke; however, the majority of dissections are asymptomatic and do not warrant invasive therapy. The treatment of carotid and vertebral artery dissections has evolved significantly since the early diagnosis and management…
Since the first description of a carotid endarterectomy (CEA) for the prevention of stroke, the operation has been widely debated and often criticized; yet the number of endarterectomy procedures performed annually has steadily increased. Early studies suggested that medical management…
Introduction The many advantages of endovascular treatment of cerebral aneurysms are well documented. Acceptance and use of endovascular techniques have steadily increased and has been bolstered by publication of the results of the International Subarachnoid Aneurysm Trial (ISAT) in 2005.…
Introduction Surgical treatment of cerebrovascular disorders with cerebral revascularization procedures has remained a formidable task for neurosurgeons for centuries. Despite remarkable advances in medical management and noninvasive procedures, cerebrovascular revascularization with extracranial-intracranial (EC-IC) bypass procedures has withstood the test of…
Tumors in the cerebellopontine angle and internal auditory canal can result in hearing loss. In addition, surgical resection of these tumors often leads to hearing impairment due to manipulation and/or sacrifice of the cochlear nerve. Options for restoring hearing include…
Acknowledgment Portions of this chapter are reproduced with permission from Brodkey J, Vrionis FD: Surgical approaches through the temporal bone. In Robertson JT, Coakham H, Robertson JH (eds): Cranial Base Surgery: Management, Complications and Outcome . Edinburgh, Churchill Livingstone, 2000.…
Introduction Cerebello-pontine angle (CPA) surgery for vestibular schwannomas (VSs) represents a complex surgical setting that requires adequate training, sufficient microsurgical skills and experience, and a meticulous preparation about patient’s anatomy for each case. The surgeon who approaches CPA surgery must…