Abstract
Advances in the treatment of intracranial aneurysms over the last decade have focused on 1) novel surgical treatments or adjuncts to surgery and 2) alternative nonsurgical treatments. The goal of these recent developments is to reduce the morbidity associated with the treatment of aneurysms. New microsurgical techniques include the use of direct arterial occlusion (Hunterian ligation), intraoperative electrophysiological monitoring, frameless image-guided stereotaxis, and intraoperative angiograms. Endovascular therapy has evolved to provide a viable alternative in the treatment of some types of aneurysms, and in some cases, combined endovascular and microsurgical therapies are required for certain difficult to treat aneurysms. Hypothermia, both mild and deep cooling, has recently been used as a cerebroprotectant during cerebrovascular cases, particularly when temporary clipping of feeding vessels is performed. Each of these innovations has played a role in reducing the morbidity and mortality of aneurysm surgery, and will be reviewed in this article.
