Surgical Management of Aneurysms

Aneurysms occur in a variety of locations in the brain. Specialized surgical approaches exist to deal with this spectrum of aneurysms. Microsurgical technique is the basis for successful surgical treatment of aneurysms. Aneurysms that lie in subarachnoid spaces and fissures outside the brain can be accessed by carefully opening these natural corridors. Skull base surgery, which utilizes corridors through the bone of the base of the skull, is commonly used for deep and difficult aneurysms. Newer modalities for treating aneurysms, namely occluding them with platinum coils packed inside the aneurysm, are available for selected cases. Complex and giant aneurysms that cannot be treated with conventional clipping or coiling techniques are treated with more intricate procedures, including bypass operations that resupply blood flow to arteries downstream from the aneurysm so that upstream arteries filling the aneurysm can be occluded.