Giant Intracranial Aneurysms: A Case-Based Atlas of Imaging by Naci Kocer

By Naci Kocer

This atlas specializes in the imaging and treatment plans on hand for big intracranial aneurysms because Nineties at the beginning of the so-called glossy endovascular period. in this interval, there have been major advances made within the treatment of small intracranial aneurysms even though the therapy of big aneurysms persisted to pose an insurmountable problem. on the flip of this century, this grim situation steadily better with greater figuring out of the pathophysiology of huge intracranial aneurysms. This replaced state of affairs in titanic intracranial aneurysm remedy has been illustrated through informative scientific case experiences. The medical presentation of big aneurysms in adults and kids is defined as are the advantages of other imaging modalities defined and illustrated. large attention has been given to trendy fusion imaging that has greater our perception into the character of the affliction. Endovascular remedy ways (including illustrative open surgical methods) and reconstructive and deconstructive concepts are totally documented, with cautious awareness given to components that effect administration thoughts, remedy selection and complications.The atlas might be a useful reference and sensible relief for neuroradiologists, neurosurgeons, neurologists, fellowship trainees, postgraduate & graduate scholars.

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Additional resources for Giant Intracranial Aneurysms: A Case-Based Atlas of Imaging and Treatment

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1 (continued) (g) Follow-up MRI at 6 months after treatment shows no parenchymal pathology with a thrombosed and shrunken aneurysm. MRI with MRA at 18 months follow-up shows further shrinkage of the GIA with the remodeled parent artery 21 Case 4 © Springer International Publishing Switzerland 2016 N. 1007/978-3-319-41788-2_4 4 Case 4 22 Cavernous ICA GIAs Keywords: Cavernous aneurysms, Giant aneurysms 4 Introduction and Anatomy Cavernous ICA aneurysms account for 2–9 % of all intracranial aneurysms [1].

A) Radiological investigations reveal an unruptured left supraclinoid ICA GIA with the fundus pointing medially, superiorly, and posteriorly. There was poor cross circulation to the left hemisphere.  Technical challenges: (1) Peri-aneurysmal proximal and distal size discrepancy of ICA. (2) Proximal and distal supraclinoid ICA has acute angulation around the aneurysmal neck. (3) Wide aneurysmal neck. Another aneurysm on the right has already been clipped. (b) The GIA neck was crossed with a Headway 27® (MicroVention, Tustin, California).

Thus the Leo® scaffold prevents inadequate aneurysmal neck coverage and avoids the need for multiple overlapping FDs. 2. It increases the ease of SILK® delivery within the aneurysm by forming a stable construct for the FD (decreases friction between SILK® and native artery). 3. It provides a stable platform for SILK® and prevents unwieldy twisting, prolapsing or opening problems (commoner in tortuous anatomy). 4. The scaffolding technique enables use of a shorter SILK® FD that can be precisely placed across the inflow zone without compromising important side branches and perforator rich regions.

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