Korean J Cerebrovasc Surg.  2010 Jun;12(2):91-97.

Five - year Trends of Cerebrovascular Surgery in a Neurosurgical Department with a Small Volume of Practice at a Single Institute with Reference to the Endovascular Treatment

• Byun HS
• Chun HJ
• Yi HJ
• Lee YJ
• Kim HY
• Kim DW

Abstract

OBJECTIVE
In recent years, the neurosurgeon's role in managing cerebrovascular diseases (CVD) has becomes rapidly challenged and overlapped with other specialists. Furthermore, the patterns of CVD and patient recruitment have also changed. We conducted a retrospective study regarding the practical trends of CVD with reference to the management paradigms at our institute. METHOD: We reviewed all the available data, including the annual reports, the daily department records, the medical records and the radiographic films of the CVD patients who had been admitted to our Neurosurgery Department during the five years between Jan. 2004 and Dec. 2008.
RESULTS
The total numbers of CVD operations showed a slight initial increase, but then they remained steady for the latter 3 years. The number of cases of non-angiomatous hemorrhage has been relatively steady, regardless of surgery. The total numbers of treated aneurysms increased, but the main body of this increment was attributed to the initiation of endovascular treatment and increased identification of unruptured vascular lesions. Vascular malformations were sustained with a small number of cases due to referring them to other institutes for radiosurgery, except for the cases that required urgent hemorrhagic evacuation.
CONCLUSION
Hemorrhagic CVDs tended to decrease either due to increasing identification before rupture or shifting such patients into a large volume hospital. The increasing awareness of ischemic CVD, the early detection of unruptured aneurysms, and the separation of medical responsibilities from neurologists have all pushed neurosurgeons to make treatment plans in a more cooperative fashion, instead of a competitive way. Neurosurgeons should be furnished with several revolutionary surgical options to widen their scope of managing patients with CVD.

Keyword

Cerebral Aneurysms; Cerebrovascular disease; Endovascular treatment; Infarction; Subarachnoid hemorrhage

MeSH Terms

Academies and Institutes
Aneurysm
Hemorrhage
Humans
Infarction
Intracranial Aneurysm
Medical Records
Neurosurgery
Patient Selection
Radiosurgery
Retrospective Studies
Rupture
Specialization
Subarachnoid Hemorrhage
Vascular Malformations
X-Ray Film