Book contents
- Frontmatter
- Contents
- Editor biographies
- List of contributors
- Preface
- Introduction
- Part I Medical management
- Part II Surgical procedures and their complications
- 42 Tracheostomy
- 43 Thyroidectomy
- 44 Parathyroidectomy
- 45 Lumpectomy and mastectomy
- 46 Gastric procedures (including laparoscopic antireflux, gastric bypass, and gastric banding)
- 47 Small bowel resection
- 48 Appendectomy
- 49 Colon resection
- 50 Abdominoperineal resection
- 51 Anal operations
- 52 Cholecystectomy
- 53 Common bile duct exploration
- 54 Major hepatic resection
- 55 Splenectomy
- 56 Pancreatoduodenal resection
- 57 Adrenal surgery
- 58 Lysis of adhesions
- 59 Ventral hernia repair
- 60 Inguinal hernia repair
- 61 Laparotomy in patients with human immunodeficiency virus infection
- 62 Abdominal trauma
- 63 Coronary artery bypass procedures
- 64 Cardiac rhythm management
- 65 Aortic valve surgery
- 66 Mitral valve surgery
- 67 Ventricular assist devices and cardiac transplantation
- 68 Pericardiectomy
- 69 Pulmonary lobectomy
- 70 Pneumonectomy
- 71 Hiatal hernia repair
- 72 Esophagogastrectomy
- 73 Colon interposition for esophageal bypass
- 74 Carotid endarterectomy
- 75 Abdominal aortic aneurysm repair
- 76 Aortobifemoral bypass grafting
- 77 Femoropopliteal bypass grafting
- 78 Lower extremity embolectomy
- 79 Treatment of chronic mesenteric ischemia
- 80 Inferior vena cava filters
- 81 Portal shunting procedures
- 82 Breast reconstruction after mastectomy
- 83 Facial rejuvenation
- 84 Liposuction
- 85 Repair of facial fractures
- 86 Flap coverage for pressure sores
- 87 Muscle flap coverage of sternal wound infections
- 88 Skin grafting for burns
- 89 Abdominal hysterectomy
- 90 Vaginal hysterectomy
- 91 Uterine curettage
- 92 Radical hysterectomy
- 93 Vulvectomy
- 94 Craniotomy for brain tumor
- 95 Intracranial aneurysm surgery
- 96 Evacuation of subdural hematomas
- 97 Stereotactic procedures
- 98 Transsphenoidal surgery
- 99 Treatment of herniated disk
- 100 General considerations in ophthalmic surgery
- 101 Cataract surgery
- 102 Corneal transplantation
- 103 Vitreoretinal surgery
- 104 Glaucoma surgery
- 105 Refractive surgery
- 106 Eye muscle surgery
- 107 Enucleation, evisceration and exenteration
- 108 Arthroscopic knee surgery
- 109 Total knee replacement
- 110 Total hip replacement
- 111 Fractures of the femoral shaft
- 112 Surgery for hip fractures
- 113 Lumbar spine surgery
- 114 Surgery for scoliosis or kyphosis in adults
- 115 Surgery of the foot and ankle
- 116 Lower extremity amputations
- 117 Surgical procedures for rheumatoid arthritis
- 118 Otologic surgery
- 119 Myringotomy and tubes
- 120 Tonsillectomy and adenoidectomy
- 121 Uvulopalatopharyngoplasty
- 122 Endoscopic sinus surgery
- 123 Cleft palate surgery
- 124 Facial surgery
- 125 Tracheotomy
- 126 Surgical management of head and neck cancer
- 127 Anterior cranial base surgery
- 128 Surgery for syndromic craniosynostosis
- 129 Nephrectomy
- 130 Cystectomy and urinary diversion
- 131 Radical prostatectomy
- 132 Transurethral resection of the prostate (TURP)
- 133 Interstitial laser thermal therapy for benign prostatic hyperplasia
- 134 Management of upper urinary tract calculi
- 135 Female urinary incontinence surgery
- Index
- References
95 - Intracranial aneurysm surgery
Published online by Cambridge University Press: 12 January 2010
- Frontmatter
- Contents
- Editor biographies
- List of contributors
- Preface
- Introduction
- Part I Medical management
- Part II Surgical procedures and their complications
- 42 Tracheostomy
- 43 Thyroidectomy
- 44 Parathyroidectomy
- 45 Lumpectomy and mastectomy
- 46 Gastric procedures (including laparoscopic antireflux, gastric bypass, and gastric banding)
- 47 Small bowel resection
- 48 Appendectomy
- 49 Colon resection
- 50 Abdominoperineal resection
- 51 Anal operations
- 52 Cholecystectomy
- 53 Common bile duct exploration
- 54 Major hepatic resection
- 55 Splenectomy
- 56 Pancreatoduodenal resection
- 57 Adrenal surgery
- 58 Lysis of adhesions
- 59 Ventral hernia repair
- 60 Inguinal hernia repair
- 61 Laparotomy in patients with human immunodeficiency virus infection
- 62 Abdominal trauma
- 63 Coronary artery bypass procedures
- 64 Cardiac rhythm management
- 65 Aortic valve surgery
- 66 Mitral valve surgery
- 67 Ventricular assist devices and cardiac transplantation
- 68 Pericardiectomy
- 69 Pulmonary lobectomy
- 70 Pneumonectomy
- 71 Hiatal hernia repair
- 72 Esophagogastrectomy
- 73 Colon interposition for esophageal bypass
- 74 Carotid endarterectomy
- 75 Abdominal aortic aneurysm repair
- 76 Aortobifemoral bypass grafting
- 77 Femoropopliteal bypass grafting
- 78 Lower extremity embolectomy
- 79 Treatment of chronic mesenteric ischemia
- 80 Inferior vena cava filters
- 81 Portal shunting procedures
- 82 Breast reconstruction after mastectomy
- 83 Facial rejuvenation
- 84 Liposuction
- 85 Repair of facial fractures
- 86 Flap coverage for pressure sores
- 87 Muscle flap coverage of sternal wound infections
- 88 Skin grafting for burns
- 89 Abdominal hysterectomy
- 90 Vaginal hysterectomy
- 91 Uterine curettage
- 92 Radical hysterectomy
- 93 Vulvectomy
- 94 Craniotomy for brain tumor
- 95 Intracranial aneurysm surgery
- 96 Evacuation of subdural hematomas
- 97 Stereotactic procedures
- 98 Transsphenoidal surgery
- 99 Treatment of herniated disk
- 100 General considerations in ophthalmic surgery
- 101 Cataract surgery
- 102 Corneal transplantation
- 103 Vitreoretinal surgery
- 104 Glaucoma surgery
- 105 Refractive surgery
- 106 Eye muscle surgery
- 107 Enucleation, evisceration and exenteration
- 108 Arthroscopic knee surgery
- 109 Total knee replacement
- 110 Total hip replacement
- 111 Fractures of the femoral shaft
- 112 Surgery for hip fractures
- 113 Lumbar spine surgery
- 114 Surgery for scoliosis or kyphosis in adults
- 115 Surgery of the foot and ankle
- 116 Lower extremity amputations
- 117 Surgical procedures for rheumatoid arthritis
- 118 Otologic surgery
- 119 Myringotomy and tubes
- 120 Tonsillectomy and adenoidectomy
- 121 Uvulopalatopharyngoplasty
- 122 Endoscopic sinus surgery
- 123 Cleft palate surgery
- 124 Facial surgery
- 125 Tracheotomy
- 126 Surgical management of head and neck cancer
- 127 Anterior cranial base surgery
- 128 Surgery for syndromic craniosynostosis
- 129 Nephrectomy
- 130 Cystectomy and urinary diversion
- 131 Radical prostatectomy
- 132 Transurethral resection of the prostate (TURP)
- 133 Interstitial laser thermal therapy for benign prostatic hyperplasia
- 134 Management of upper urinary tract calculi
- 135 Female urinary incontinence surgery
- Index
- References
Summary
Intracranial aneurysms are a relatively common disorder with an autopsy prevalence of 2% to 5% in the general population. Nearly half of these aneurysms become symptomatic during the patient's lifetime, usually presenting as subarachnoid hemorrhage (SAH). In North America, approximately 28 000 cases of aneurysmal SAH occur each year, mostly in adults. As opposed to the fusiform aneurysms that are encountered in the extracranial peripheral vasculature, intracranial aneurysms are typically saccular with a well-defined neck and sac distinct from the lumen of the parent vessel, frequently at proximal intracranial arterial branching points. Although the pathophysiology of intracranial aneurysms is controversial, they are thought to arise from defects in the muscularis media which may be congenital or acquired. Once these aneurysms have developed, conditions like hypertension and tobacco smoking may increase the risk of rupture, leading to SAH. Unruptured aneurysms are believed to bleed at varying rates according to multiple factors, including their diameter at the time of diagnosis. Although evidence suggests that intracranial aneurysms are less likely to bleed if they are less than 7 to 10 mm, both angiographic and direct intraoperative observational studies have demonstrated that even smaller aneurysms may rupture. About 40% to 50% of patients die within the first month as a result of the initial hemorrhage and its complications. Of those who survive, approximately 20% succumb to rebleeding in the ensuing 2 weeks (50% in 6 months) if the aneurysms are not treated, with the highest rate of recurrent hemorrhage (4%) during the first 24 hours after initial rupture.
- Type
- Chapter
- Information
- Medical Management of the Surgical PatientA Textbook of Perioperative Medicine, pp. 674 - 677Publisher: Cambridge University PressPrint publication year: 2006