Indications Spontaneous intracerebral hemorrhage (ICH). Deep-seated and lobar hematomas with suspected underlying hypertension or cerebral amyloid angiopathy. Moderate-sized and large hematomas (> 20 mL). Normal coagulation parameters (international normalized ratio [INR] < 1.3, prothrombin time < 14, and partial thromboplastin…
Additional videos for this topic are available online at . Indications Symptomatic intracerebral hemorrhage (ICH) causing progressive neurologic symptoms or impending cerebral herniation syndromes is best managed with open evacuation, especially in younger patients. ICH that is associated with…
The authors wish to thank Takanori Fukushima for work on the previous edition’s version of this chapter. Additional videos for this topic are available online at . Indications Despite advances in endovascular neurosurgery, cerebral bypass operations remain essential components…
Indications Atherosclerotic carotid artery occlusion with hemodynamic insufficiency in patients that have suffered symptomatic ischemia despite best medical therapy. In nonselected patient populations, a multicenter randomized controlled trial showed no benefit of superficial temporal artery–middle cerebral artery (STA–MCA) bypass for…
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…