Cerebral Aneurysm Clipping

Subarachnoid hemorrhage (SAH) is usually caused by the rupture of an intracranial aneurysm. Craniotomy and surgical management has been the traditional treatment for decades until the development and evolution of endovascular techniques. Operative clipping of cerebral aneurysms is performed less frequently, but the procedure is still required for aneurysms that are not amenable to endovascular coiling. Some centers do not have the skilled personnel to perform endovascular techniques, and craniotomy is therefore necessary to treat the aneurysm and prevent the problem of rebleeding and avoid vasospasm. This discussion will address specifically the perioperative management of surgical clipping for intracranial aneurysms.