Intracranial saccular

Brunereau L, Cottier JP, Sonier CB, Medioni B, Bertrand P, Rouleau P, Sirinelli D, Herbreteau D (1999) Prospective evaluation of time-of-flight MR angiography in the follow-up of intracranial saccular aneurysms treated with Guglielmi detachable coils. J Comput Assist Tomogr 23 216-223... 

Primary intracerebral hemorrhage is more common than subarachnoid hemorrhage, and its incidence increases with age (see Fig. 1.1). It is more frequent in Southeast Asian, Japanese and Chinese populations than in whites. The most common causes are intracranial small vessel disease, which is associated with hypertension, cerebral amyloid angiopathy and intracranial vascular malformations (Sutherland and Auer 2006). Rarer causes include saccular aneurysms, hemostatic defects, particularly those induced by anticoagulation or therapeutic thrombolysis, antiplatelet drugs, infective endocarditis, cerebral vasculitis and recreational drug use (Neiman et al. 2000 O Connor et al. 2005). 

Intracranial aneurysms are not congenital but develop over the course of life. Approximately 10% of aneurysms are familial, and candidate genes identified thus far include those coding for the extracellular matrix. Saccular aneurysms tend to occur at branching points on the circle of Willis and proximal cerebral arteries approximately 40% on the anterior communicating artery complex, 30% on the posterior communicating artery or distal internal carotid artery, 20% on the middle cerebral artery and 10% in the posterior... 

Polyurethane adhesives in neurosurgery. KL-3 has been widely used in the following surgical situations [421] recovery of potency of cerebral arteries with saccular anemysms that cannot be eliminated from the circulation plasty of cerebral fistulas in the anterior cranial fossa the closing of defects in the dura mater plasty of trepanation holes fixation of bone fragments in craniotomic defects and sealing of extra- and intracranial anastomoses. 

Saccular aneurysms are berry-like vessel outpouch-ings mostly arising from arterial bifurcations and account for 66%-98% of intracranial aneurysms (Yong-Zhong and van Alphen 1990). The vast majority of aneurysms (85%) are located in the anterior and only 15% are located in the posterior circulation (Kassell and Torner 1983). 

Saccular aneurysms of spinal arteries are rare. The clinical features of spinal SAH are usually associated with those of a transverse spinal cord lesion but may mimic SAH due to an intracranial aneurysm (Mohsenipour et al. 1994, Kocak et al. 2006). 

Aneurysms of the posterior circulation account for about 15% of all intracranial aneurysms saccular aneurysms and those of the basilar tip are the most frequent accounting for 5%-8% of all intracranial aneurysms. Ruptured aneurysms in the posterior circulation have a worse prognosis than patients with a ruptured aneurysm in another location (Schievink et al. 1995) and early rerupture occurs more often in this location. Despite improvement in microsurgi-cal therapy, clipping for posterior circulation aneurysms remains challenging. The main problems are the deep location, the presence of many eloquent... 

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