Surgical treatment of intracranial aneurysms.

Intracranial aneurysms are dangerous lesions which may produce sudden death or neurological devastation in people who are often otherwise completely healthy. The definitive treatment for most of these lesions in microsurgical repair, and the cure rate is quite high. The indications for surgery include an accessible aneurysm in a patient who is healthy enough to tolerate general anesthesia and a major intracranial procedure. The timing of surgery following subarachnoid hemorrhage is still controversial, but early surgery is currently recommended for patients who are alert. Preoperative imaging studies are crucial in defining the precise anatomy of the aneurysm and any associated lesions and anomalies. Surgical approaches and techniques, anesthetic considerations, postoperative radiographic evaluation, overall results, and complications are discussed in this article.