title: The art of cerebral aneurysms-3 decades of postoperative drawings: review, classification, and efficacy for training.
abstract: OBJECTIVE
  To focus on postoperative drawings of aneurysms, which serve as visual records and teaching tools for neurosurgeons and reinforce three-dimensional vascular configurations that are specific for different cerebral aneurysms, and examine experience with this technique, particularly in regard to the training of neurosurgical residents.
  
  
  METHODS
  After performing craniotomy for aneurysm treatment, formal postoperative drawings were created and reviewed. Microsurgical issues graphically highlighted included the totality of aneurysmal dome anatomy, position of visible and hidden branch vessels, rupture points, clipping techniques, and location of adjacent cranial nerves. Drawings were cataloged and categorized according to location.
  
  
  RESULTS
  Over a 28-year period, during a continuous series of 1480 microsurgically treated aneurysms, 619 drawings (221 of anterior cerebral artery, 154 of middle cerebral artery, 214 of internal carotid artery, 30 of posterior circulation) were created. Postoperative drawings in each location were presented and reviewed. Drawings demonstrated site-specific microsurgical approaches, morphologies, and points of obscuration and rupture.
  
  
  CONCLUSIONS
  Creation and review of postoperative drawings are important adjuncts for the development of three-dimensional understanding of aneurysmal anatomy. This classic art has impact in the digital age and allows patterns of morphology, projection, and anatomy to be reinforced. Surgical atlases created from postoperative drawings function as reference and teaching tools. The creation of postoperative drawings should be a routine part of the training and methodology of vascular neurosurgeons.
authors.affiliation: Department of Neurosurgery, Hofstra North Shore-Long Island Jewish School of Medicine, and North Shore-Long Island Jewish Health System, Manhasset, New York, USA.
authors.forename: Erez
authors.initials: E
authors.lastname: Nossek
authors.affiliation: Department of Neurosurgery, Hofstra North Shore-Long Island Jewish School of Medicine, and North Shore-Long Island Jewish Health System, Manhasset, New York, USA. Electronic address: Dchalif@nshs.edu.
authors.forename: David J
authors.initials: DJ
authors.lastname: Chalif
mesh_terms: D017542:Aneurysm, Ruptured / Q000473:pathology; D002536:Cerebral Arteries / Q000033:anatomy & histology / Q000473:pathology; D003399:Craniotomy; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology* / Q000601:surgery*; D008488:Medical Illustration; D008866:Microsurgery; D009493:Neurosurgery / Q000193:education*; D011184:Postoperative Period
keywords: Aneurysm; Art; Medical illustration; Neurosurgical training