Acute Aneurysm Surgery Pathophysiology and Management

During recent years, major advances in surgical techniques, diagnostic methods, anesthesia and adjunctive treatment in the care of patients with subarachnoid hemorrhage have been achieved. Nevertheless, the overall outcome of patients with SAH cannot be regarded as satisfactory. The first part of the book concentrates on the pathogenetic mechanisms underlying vasospasm and edema, the principal causes of poor outcome. Recent progress in the field of membrane lipid metabolism has allowed the problem to be approached from an entirely new perspective. The possible participation of free radicals, membrane lipids and eicosanoids is thoroughly discussed. The second part features the problems of practical management of SAH patients. Timing and indication of surgery of aneurysms and the surgical techniques are described in detail.

I. Introduction.- II. Acute Ischemic Neurological Deficits: AINDs.- III. Delayed Ischemic Neurological Deficits (DINDs).- IV. Relevance of the Metabolism of Membrane Lipids to Cerebral Vasospasm and Ischemic Brain Damage.- V. Grading of Risk, Angiography and Computerized Tomography.- VI. Surgical Indications and Decision Making.- VII. Perioperative Care.- VIII. Surgical Techniques.- IX. Résumé.- References.