Central skull base vascular lesions
Intracranial vascular lesions (aneurysms and AVMs) are divided into two primary groups, those involving the carotid system and those of the vertebrobasilar system. In the following four sections, carotid and vertebrobasilar aneurysms will be discussed wit
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Microsurgical Anatomy and Surgery of the Central Skull Base
in collaboration with Larry Rogers
Springer-Verlag Wien GmbH
Vinko V. Dolenc Department of Neurosurgery, University Medical Centre Ljubljana, Slovenia
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© 2003 Springer-Verlag Wien Originally published by Springer-Verlag Wien New York in 2003
Typesetting: SNP Sest-set Typesetter Ud., Hong Kong
SPIN: 10637891
With 189 partly coloured Figures
CIP data applied for
ISBN 978-3-7091-7234-6 ISBN 978-3-7091-6059-6 (eBook) DOI 10.1007/978-3-7091-6059-6
Preface Parkinson's idea of crossing the dura from intradural to epidural space to repair arteriovenous fistulae and aneurysms of the parasellar space (P5) was a revolutionary step toward devising a surgical method for treating these difficult pathologies. Yet, owing to the difficulties and potential complications attendant to cardiac standstill and extracorporeal circulation, the idea was not universally accepted in the surgical community. The application of endovascular techniques, as introduced by 5erbinenko, amounted to another major breakthrough in the treatment of these lesions. For a time, the endovascular method brought the development of surgical procedures for parasellar space (P5) lesions to a resounding halt. Combining, however, the results of anatomical studies by Taptas, Parkinson and Glasscock, the concept of opening the P5 without manipulating heart function was born. Access could be gained simply by locally and temporarily interrupting internal carotid astery (ICA) flow. When this idea was presented as an alternative for treating P5 tumors and vascular lesions at the 7th International Neurosurgical Congress in Munich in 1981, opposition was generalized but not universal. Neurosurgeons demanded proof that such methods afforded successful, safe treatment of P5 lesions, that a sizable series of good postoperative results be established. The presentation of these new anatomical concepts kindled the imaginations of neurosurgeons around the world, but not always to the benefit of their patients. In many cases actions were taken without appreciation of the technical difficulties involved. As neurosurgeons flocked to put theory into practice, poor results occurred. All too often th
