Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Part 2 Surgical Procedures and their Complications
- Section 17 General Surgery
- Section 18 Cardiothoracic Surgery
- Section 19 Vascular Surgery
- Section 20 Plastic and Reconstructive Surgery
- Section 21 Gynecologic Surgery
- Section 22 Neurologic Surgery
- Chapter 102 Craniotomy for brain tumor
- Chapter 103 Intracranial aneurysm surgery
- Chapter 104 Evacuation of subdural hematomas
- Chapter 105 Stereotactic procedures
- Chapter 106 Transsphenoidal surgery
- Chapter 107 Treatment of the herniated disc
- Section 23 Ophthalmic Surgery
- Section 24 Orthopedic Surgery
- Section 25 Otolaryngologic Surgery
- Section 26 Urologic Surgery
- Index
- References
Chapter 103 - Intracranial aneurysm surgery
from Section 22 - Neurologic Surgery
Published online by Cambridge University Press: 05 September 2013
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Part 2 Surgical Procedures and their Complications
- Section 17 General Surgery
- Section 18 Cardiothoracic Surgery
- Section 19 Vascular Surgery
- Section 20 Plastic and Reconstructive Surgery
- Section 21 Gynecologic Surgery
- Section 22 Neurologic Surgery
- Chapter 102 Craniotomy for brain tumor
- Chapter 103 Intracranial aneurysm surgery
- Chapter 104 Evacuation of subdural hematomas
- Chapter 105 Stereotactic procedures
- Chapter 106 Transsphenoidal surgery
- Chapter 107 Treatment of the herniated disc
- Section 23 Ophthalmic Surgery
- Section 24 Orthopedic Surgery
- Section 25 Otolaryngologic Surgery
- Section 26 Urologic Surgery
- Index
- References
Summary
Data on the prevalence of intracranial aneurysms in the general population come from autopsy and from angiography series. A recent review found that the prevalence of intracranial aneurysms for adults without a history of subarachnoid hemorrhage (SAH) is approximately 2%, with a male to female ratio of approximately 1 to 1.3. The same analysis found that the prevalence of aneurysms increases with age, peaking in the 69–79 year age group. Nearly half of all intracranial aneurysms become symptomatic during the patient's lifetime, usually presenting as subarachnoid hemorrhage. In North America, approximately 28,000 cases of aneurysmal SAH occur each year, mostly in adults.
As opposed to fusiform aneurysms, which are encountered in the extracranial peripheral vasculature, intracranial aneurysms are typically saccular in morphology. Intracranial aneurysms possess a well-defined neck and sac distinct from the lumen of the parent vessel and are frequently located at proximal intracranial arterial branching points. Although the pathophysiology of intracranial aneurysms is controversial, they are thought to arise from defects (congenital or acquired) in the muscularis media. Once an aneurysm has developed, conditions such as hypertension and tobacco smoking will likely increase the risk of rupture, leading to SAH. Certain conditions (e.g., autosomal dominant polycystic kidney disease, Ehlers-Danlos syndrome type IV, Alpha-1 Antitrypsin Deficiency (A-1ATD)) are associated with the formation of cerebral aneurysms, presumably from the predisposition for the development of focal weak spots in vessel walls near arterial branch points.
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- Chapter
- Information
- Medical Management of the Surgical PatientA Textbook of Perioperative Medicine, pp. 670 - 674Publisher: Cambridge University PressPrint publication year: 2013