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July 11, 1990

Surgical Techniques for Saccular and Giant Intracranial Aneurysms

JAMA. 1990;264(2):265-266. doi:10.1001/jama.1990.03450020117039

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


This volume encompasses the surgical experience with intracranial aneurysms from 1969 to 1988 at the Mayo Clinic: 1634 cases of which 1096 were saccular, 215 globular, and 323 giant. It is Thoralf Sundt at his best. As he writes in the preface, it is "quite simply a 'how we do it book,'" and its pages are an atlas of the Mayo techniques.

After a nice historical review, the book is divided into four parts that contain chapters on "Basic Considerations," "Aneurysms of the Anterior Circulation," "Aneurysms of the Posterior Circulation," and "Pediatric Aneurysms."

"Basic Considerations" contains brief chapters on circulatory physiology, pathophysiology, clinical evaluation, and perioperative care wherein Dr Sundt's well-known personal management methods emerge—eg, administering isoproterenol and lidocaine in the management of vasospasm and highdose steroids to prevent its angiopathy. In delayed operations from 1969 through 1977 involving the first 310 patients, 7 died or moved to a lower