Spontaneous Subarachnoid Haemorrhage PDF : Well-known and New Approaches
Johann Wolfgang von Goethe once wrote: “Certain books seem to be written, not that we might learn from them, but in order that we might see how much the author knows.” This is not the intention here. This book is far more in keeping with the writings of Thomas Aquinas: “Wonder is the desire for knowledge.” In retrospect, the various advances in the treatment of spontaneous subarachnoid haemorrhage reflect the changes that have taken place not only in neurosurgery but in medicine and medical technology as a whole. The treatment of aneurysms has progressed from surgical ligation of the carrier vessel to the use of complex radiological endovascular and neurosurgical revascularisation methods. The most significant steps in this journey were not taken until recent decades tightly interwoven with the work of our partners especially in Neuroradiology. The improved diagnostics contributed significantly to the development of the surgical treatment of aneurysms. Yet it also has triggered the shift from open operation to endovascular treatment. A development not at its end, encompassing the great danger of dissociation between treatment and patient care – just as the handling of patients with subarachnoid haemorrhage has become a multidisciplinary field. An achievement that – while not denying the significance and the pivotal role of the individual neurosurgeon – shifts the focus onto the well-being of the patient. More and more studies are demonstrating that surgery is not the first, let alone the only possible treatment. Consequently, the number of those mastering this art with both virtuosity and versatility is dwindling. The number of vascular neurosurgeons is declining with the number of procedures that have to be performed on the vascular system supplying the brain. It would appear that many surgical procedures will also be replaced by endovascular therapies in the future.