Introduction Intracranial aneurysms are abnormal focal dilations of blood vessels in the brain that result in weakening of the vessel wall making it more prone to rupture. They are common acquired lesions that are usually saccular. Rupture of an intracranial…
Introduction Nearly 30,000 Americans suffer from aneurysmal subarachnoid hemorrhage (SAH) every year, and the overall mortality rate is 40% . About 5–15% of all intracranial aneurysms are located in the posterior circulation . The posterior circulation provides the blood supply…
Cerebellar hemorrhage and cerebellar infarction are two clinical entities with entirely different pathophysiologies, although the clinical syndromes are quite similar and the surgical management and operative considerations are nearly identical. For this reason, surgical treatment of either cerebellar hemorrhage or…
Introduction The stroke risk and management principles for symptomatic internal carotid artery (ICA) stenosis are relatively well established and have a wide consensus among practicing clinicians, discussed in Chapter 80 . The same, however, cannot be said for management of…
Introduction Large-vessel arteriosclerotic disease and stenosis, most commonly of the extracranial carotid artery bifurcation and simply referred to as carotid stenosis, accounts for 15–20% of cerebral ischemic events. The two main mechanisms for these events are hemodynamic compromise, as the…
Introduction The first surgical procedures on patients with massive infarctions were performed to alleviate severe brain swelling often erroneously attributed to a tumor. With the common use of computed tomography (CT) and magnetic resonance imaging (MRI), the pathophysiologic cause of…
Abbreviations 3D three dimensional ACoA anterior communicating artery ADAPT a direct aspiration first-pass technique AP anteroposterior AVM arteriovenous malformation CT computed tomographic CTA CT angiography DMSO dimethyl sulfoxide DSA digital subtraction angiography FRED Flow redirection endoluminal device IA intracranial aneurysm…
Introduction Vasculitis, in general, is the inflammation of blood vessels. However, not all cases of vasculitis are identical. Vasculitis can vary based on a number of characteristics such as size of blood vessel involved, target organs, etiology, and the underlying…
Introduction Every year, stroke affects more than 15 million patients worldwide, resulting in death in 5.7 million patients and disability in another 5 million . Neuropsychiatric disorders are common after stroke, including depression, anxiety, agitation, mania, apathy, emotional lability, psychosis,…
Frequency and Pathogenesis Nonvalvular atrial fibrillation (AF) is a potent predictor of first and recurrent stroke, affecting more than 2.7 million Americans. An estimated 14–38% of patients with ischemic stroke have AF . The frequency of ischemic stroke events in…