title: Treatment of cerebral aneurysms-surgical clipping or endovascular coiling: the guiding principles.
abstract: Cerebral aneurysms represent common intracranial vascular lesions encountered in neurosurgical practice. The clinical presentation is varied, ranging from asymptomatic lesions to those presenting with catastrophic intracranial hemorrhage. Aneurysm treatment has been a rapidly evolving field with numerous technical innovations, especially in the last two decades. Selecting the appropriate treatment can be a complex process that involves integration of information regarding the patient's clinical presentation, associated comorbidities, the aneurysm's morphological characteristics, safety and efficacy of the treatment options and skill and experience of available practitioners, amongst others. In this article, we review each of these factors and appraise the available scientific evidence in an effort to facilitate decision making in the treatment of cerebral aneurysms. The treatment of intracranial aneurysms is best performed at high volume centers that utilize a multidisciplinary, team-based approach.
authors: Division of Interventional Neuroradiology, University of Maryland Medical Center, Baltimore, Maryland.
authors: Ravishankar
authors: R
authors: Shivashankar
authors: Division of Interventional Neuroradiology, University of Maryland Medical Center, Baltimore, Maryland.
authors: Timothy R
authors: TR
authors: Miller
authors: Division of Interventional Neuroradiology, University of Maryland Medical Center, Baltimore, Maryland.
authors: Gaurav
authors: G
authors: Jindal
authors: Department of Neurosurgery, University of Maryland Medical Center, Baltimore, Maryland.
authors: J Marc
authors: JM
authors: Simard
authors: Department of Neurosurgery, University of Maryland Medical Center, Baltimore, Maryland.
authors: E Francois
authors: EF
authors: Aldrich
authors: Division of Interventional Neuroradiology, University of Maryland Medical Center, Baltimore, Maryland.
authors: Dheeraj
authors: D
authors: Gandhi
mesh_terms: D057510:Endovascular Procedures / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000601:surgery*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods / Q000592:standards; D017410:Practice Guidelines as Topic / Q000592:standards*; D013525:Surgical Instruments / Q000592:standards*; D016896:Treatment Outcome