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Vascular Lesions of the Skull Base

  • Takanori FukushimaEmail author
  • Goh Inoue
  • Ali Zomorodi
  • Alexander König
  • Marcel Biegler
  • Uwe Spetzger
  • Nikolai J. Hopf
  • Robert Reisch
  • Peter Kurucz
Chapter

Abstract

Cerebrovascular diseases of the skull base represent a separate entity. Especially aneurysms located close to the skull base as well as dural arteriovenous fistulas require highly specialized neuroradiological diagnostics and an individualized treatment strategy being exactly tailored to the lesion. For different reasons there has been a shift to endovascular treatment of these vascular lesions of the skull base over the years. Modern supraselective microcatheters and further development and improvement of the different embolization materials nowadays allow a very selective occlusion of arteriovenous malformations. Furthermore, the ongoing development of endovascular coil technology and especially the modern methods of vessel wall reconstruction by stents have pushed back the complex surgical procedures for the microsurgical clipping of skull base aneurysms. But nevertheless, endovascular procedures will not completely replace microsurgical therapy in the foreseeable future. A problem for the younger generation and especially for the practical training of young skull base surgeons is the decreasing number of neurovascular cases due to the increasing number of endovascular cases. Furthermore, often very complex cases that are very difficult to operate on remain for microsurgical therapy.

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Takanori Fukushima
    • 1
    Email author
  • Goh Inoue
    • 2
  • Ali Zomorodi
    • 2
  • Alexander König
    • 3
  • Marcel Biegler
    • 3
  • Uwe Spetzger
    • 3
  • Nikolai J. Hopf
    • 4
  • Robert Reisch
    • 5
  • Peter Kurucz
    • 6
  1. 1.Division of Neurosurgery, Duke University Medical Center, Carolina Neuroscience InstituteRaleighUSA
  2. 2.Department of Neurosurgery, Duke University, INERFRaleighUSA
  3. 3.Neurochirurgische Klinik, Klinikum KarlsruheKarlsruheGermany
  4. 4.NeuroChirurgicumStuttgartGermany
  5. 5.ENDOMIN – Zentrum für endoskopische und minimalinvasive NeurochirurgieZürichSwitzerland
  6. 6.Neurochirurgische Klinik, Klinikum Stuttgart, KatharinenhospitalStuttgartGermany

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