Neurosurgical Management of Aneurysmal Subarachnoid Haemorrhage

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I.A. Langmoen, Tryggve Lundar, Rune Aaslid, Hans-J. Reulen
Springer Science & Business Media, Apr 19, 1999 - Medical - 175 pages
The small neck of the aneurysm afforded an easy surgical attack. An ordinary flat silver clip was placed over the sac and tightly compressed obliterated it completely. The clip was flush with the wall of the carotid artery. The sac, lateral to the silver clip, was then picked up with the forceps and thrombosed by the electocautery. Walter Dandy reporting his successful operation of a posterior communicating aneurysm on March 23, 1937. Walter Dandy's patient left the hospital in good health 2 weeks later, and from his report one may gain the impression that the operation was an easy task. Despite continuous developments during the following decades, it was not until the introduction of the operating microscope and microsurgical techniques that surgical treatment was generally accepted. During the microsurgical era surgical results have continued to improve due to diagnostical, neuroanaesthesi ological, and microsurgical refinements, and improved neurointensive care. Endovascular obliteration has become an important treatment alternative but this has not been included in this particular volume. The purpose of the present supplement of the ACTA NEUROCHIRURGICA is to review some of the elements in the neurosurgical management of patients with aneurysmal subarachnoid haemorrhage that are important for a successful outcome. Professor Helge Nornes has been a major force in the development of new techniques and research strategies in this area for a number of years and has recently retired from the National Hospital in Oslo.
 

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Contents

A Tribute to Helge Nornes
1
Intracranial Aneurysms and Subarachnoid Hemorrhage Management of the Poor Grade Patient
7
Etiology of Cerebral Vasospasm
27
Hemodynamics of Cerebrovascular Spasm
47
The Role of Transcranial Doppler in the Management of Patients with Subarachnoid Haemorrhage a Review
59
Neurointensive Care of Aneurysmal SAH
73
Virtues and Drawbacks of Titanium Alloy Aneurysm Clips
81
A Combined TransorbitalTransclinoid and Transsylvian Approach to CarotidOphthalmic Aneurysms Without Retraction of the Brain
89
Extradural Approach to Intracavernous ICA Aneurysms
99
Surgical Treatment of Anterior Circulation Aneurysms
107
Technical Strategies Based on Angiographic Anatomical Findings and the Results of 60 Recent Consecutive Cases
123
Surgical Strategies for Giant Intracranial Aneurysms
141
Functional Outcome After Aneurysmal Subarachnoid Hemorrhage
157
Author Index
175
Index of Keywords
177
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