Preoperative Image Assessment of Cerebral Aneurysms and the Management of Critical Intraoperative Findings(<SPECIAL ISSUE>Topics of Therapy for Cerebral Aneurysms)

DOI Web Site 1 Citations 28 References Open Access

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Other Title
  • 脳動脈瘤クリッピング術の術前画像検査と戦術上重要な術中所見(<特集>脳動脈瘤治療のトピックス)
Published
2010
DOI
  • 10.7887/jcns.19.133
Publisher
The Japanese Congress of Neurological Surgeons

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Description

Digital subtraction angiography (DSA) has been the main technique used for the detection and characterization of intracranial aneurysms and still remains the gold standard. However, DSA is invasive and time consuming, and carries a risk of both neurological and non-neurological complications. In addition, DSA may increase the risk of rebleeding when examining acute stage subarachnoid hemorrhage. It has been demonstrated that three-dimensional (3D) CT can reliably detect intracranial aneurysms. Therefore, a review of the recent literature concerning the diagnostic values of 3D-CT for preoperative aneurysm assessment was performed. Employing even the most advanced technology, intraoperative findings are not always well or fully depicted before surgery. Among them, the vessel wall findings including arterioscrelosis, condition of the perforators, and the status of the aneurysm occlusion are critical to the surgical outcome. Therefore, the detection and management of these important intraoperative findings were also illustrated.

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