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BACKGROUND AND PURPOSE This prospective study was conducted to compare the outcomes of surgical clipping and endovascular treatment in acute (<72 hours) aneurysmal subarachnoid hemorrhage (SAH). METHODS One hundred nine consecutive patients were randomly assigned to either surgical (n=57) or endovascular (n=52) treatment. Clinical and neuropsychological(More)
BACKGROUND Anterior communicating artery complex is the most frequent site of intracranial aneurysms in most reported series. Anterior communicating artery aneurysms are the most complex aneurysms of the anterior circulation due to the angioarchitecture and flow dynamics of the ACoA region, frequent anatomical variations, deep interhemispheric location, and(More)
BACKGROUND Delayed ischemic neurologic deficit (DIND) is a serious complication of acute aneurysmal subarachnoid hemorrhage (aSAH). Although oral nimodipine is accepted as standard care for the prevention of DIND, the intravenous route is preferred by several centers. In the present study we compared the clinical efficacy between enteral and intravenous(More)
BACKGROUND Of the MCA aneurysms, those located at the main bifurcation of the MCA (MbifA) are by far the most frequent. The purpose of this article is to review the practical anatomy, preoperative planning, and avoidance of complications in the microsurgical dissection and clipping of MbifAs. METHODS This review, and the whole series on intracranial(More)
BACKGROUND Distal middle cerebral artery aneurysms originate from branches of MCA distal to its main bifurcation or the peripheral branches. Distal middle cerebral artery aneurysms are the least frequently seen among the middle cerebral artery aneurysms. The purpose of this article is to review the practical anatomy, preoperative planning, and avoidance of(More)
BACKGROUND The M1As are located in the main trunk (M1) of the MCA, between the bifurcation of the ICA and the main bifurcation of M1. Proximal MCA aneurysms are often small and thin-walled, which makes their proper clipping tedious. There are few reports on their microsurgery. METHODS This review, and the whole series on intracranial aneurysms, is mainly(More)
BACKGROUND AND PURPOSE Ventricular dilation and sulcal enlargement are common sequelae after aSAH. Our aim was to quantify the late ventricular dilation and volumes of the CSF spaces after aSAH and to determine if they correlate with neurologic and cognitive impairments frequently detected in these patients. MATERIALS AND METHODS 3D T1-weighted images(More)
OBJECTIVE To assess whether subarachnoid hemorrhage (SAH) and its treatment is followed by volume loss in temporomesial structures. METHODS One hundred fifty-five consecutive patients with aneurysmal SAH were randomly assigned to surgical or endovascular treatment. Volumetric MRI was performed in 77 SAH patients with good or moderate clinical outcome 1(More)
Microneurosurgical techniques introduced by Prof Yasargil in the 1960s have increased the neurosurgeon's ability to operate in small and often very narrow and deep gaps. Microneurosurgical techniques-ensuring an almost bloodless field and mostly obviating need for transfusion-should be atraumatic and noninvasive to the already lesioned central nervous(More)