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Brain Sciences
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Advances in the Diagnosis, Visualization and Treatment of Intracranial Aneurysms...
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Advances in the Diagnosis, Visualization and Treatment of Intracranial Aneurysms and Subarachnoid Hemorrhage

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurosurgery and Neuroanatomy".

Deadline for manuscript submissions: 31 January 2026 | Viewed by 3613

Special Issue Editors

Prof. Dr. Serge Marbacher

E-Mail Website
Guest Editor
Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland
Interests: intracranial aneurysm; subarachnoid hemorrhage; delayed cerebral vasospasm; animal models; neurosurgery; aneurysm wall biology
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Lukas Andereggen

E-Mail Website
Guest Editor
1. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland
2. Faculty of Medicine, University of Bern, Bern, Switzerland
Interests: vascular neurosurgery; interventional neuroradiology; intracranial aneurysm; subarachnoid hemorrhage; cerebral vasospasm; neuroplasticity; neuroregeneration

Special Issue Information

Dear Colleagues,

We are excited to announce a Special Issue of Brain Sciences dedicated to the diagnosis, treatment, and visualization of intracranial aneurysms and subarachnoid hemorrhage (SAH). We invite submissions of experimental preclinical studies and clinical research, including original articles, patient series, and case reports, as well as comprehensive reviews and expert commentaries—spanning advanced microsurgical and endovascular strategies to novel imaging, 3D modelling, and patient follow-up.

Intracranial aneurysms and subarachnoid hemorrhage remain among the most challenging neurovascular conditions, frequently necessitating rapid diagnosis and tailored, patient-specific intervention. Treatment paradigms have evolved significantly in recent years, incorporating surgical clipping and endovascular coil embolization techniques, while being augmented by cutting-edge imaging, 3D visualization, and mixed reality tools for better treatment planning. At the same time, concerns around cost-effectiveness, long-term surveillance imaging, the role of artificial intelligence, and clinical outcome measures continue to shape the discourse on optimal management strategies.

The goal of this Special Issue is to highlight technological, clinical, and translational innovations that are shaping the future of aneurysm and SAH care. We aim to showcase multidisciplinary contributions that push the boundaries of how we visualize, understand, and treat these life-threatening conditions.

Topics of Interest:

  • Diagnosis and management of intracranial aneurysms;
  • Subarachnoid hemorrhage: acute treatment and outcome predictors;
  • Surgical clipping vs. endovascular coiling: current perspectives and innovations;
  • Advanced imaging techniques (CT angiography, DSA, MRI) in aneurysm and SAH care;
  • 3D visualization and simulation technologies;
  • 3D-printed aneurysm models for surgical planning and education;
  • Integration of augmented/mixed reality in neurovascular procedures;
  • Cost-effectiveness analyses in aneurysm treatment strategies;
  • Long-term imaging follow-up and surveillance protocols;
  • Translational models and simulations of aneurysm formation and rupture;
  • AI-enhanced applications;
  • Patient-specific planning using computational and anatomical modelling;
  • Multidisciplinary approaches to complex cerebrovascular cases.

We welcome contributions from a broad range of disciplines, including neurosurgery, neuroradiology, neurology, and biomedical engineering. With this Special Issue, our goal is to provide a high-impact platform that captures the current landscape and future directions in the care of aneurysms and subarachnoid hemorrhage—both in clinical practice and research.

Prof. Dr. Serge Marbacher
Prof. Dr. Lukas Andereggen
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neurovascular
  • intracranial aneurysm
  • subarachnoid hemorrhage
  • education and teaching
  • imaging technology
  • hybrid operating room
  • augmented reality
  • cerebrovascular disease
  • cost-effectiveness
  • artificial intelligence

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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15 pages, 1150 KB  
Article
Minimally Invasive Supraorbital vs. Traditional Pterional Approaches in Unruptured Aneurysm Surgery: Evaluating Risks and Results
by Anna Brunner, Marlene Rainer, Uschi Pongratz, Klaus Leber, Máté Fehér, Alexander Micko and Stefan Wolfsberger
Brain Sci. 2025, 15(12), 1315; https://doi.org/10.3390/brainsci15121315 - 9 Dec 2025
Viewed by 135
Abstract
Background/Objectives: Intracranial aneurysms affect 3–5% of the population and are associated with high morbidity and mortality, particularly after rupture. Treatment options for unruptured aneurysms include microsurgical clipping, with the pterional and supraorbital approaches commonly employed. This study compares these two approaches regarding complications [...] Read more.
Background/Objectives: Intracranial aneurysms affect 3–5% of the population and are associated with high morbidity and mortality, particularly after rupture. Treatment options for unruptured aneurysms include microsurgical clipping, with the pterional and supraorbital approaches commonly employed. This study compares these two approaches regarding complications and outcomes. Methods: A retrospective analysis was conducted on 241 patients treated between 2004 and 2023 at the University Hospital of Graz. Patients underwent microsurgical clipping via the pterional (n = 170) or supraorbital (n = 71) approach, chosen according to aneurysm characteristics and surgeon preference. Data on demographics, aneurysm location and size, intraoperative complications, postoperative outcomes, and follow-up were evaluated. Results: The pterional approach was predominantly used for middle cerebral artery (MCA) aneurysms (79.2%), while the supraorbital approach was more frequently applied for internal carotid artery (ICA) and anterior communicating artery (ACOM) aneurysms. Aneurysms treated via the pterional approach were significantly larger (mean width 6.88 mm vs. 5.04 mm; p < 0.01). Severe intraoperative complications, including aneurysm rupture, were significantly more common in the supraorbital group (26.8% vs. 8.8%; p < 0.001). Postoperative hypo-/anosmia occurred more often after the supraorbital approach (8.5% vs. 1.8%; p = 0.013), while temporalis muscle atrophy (11.9% vs. 1.8%; p = 0.029) and chewing difficulties (19.5% vs. 1.8%; p = 0.002) were more frequent after the pterional approach. The supraorbital group had a shorter hospital stay (7.96 vs. 8.76 days; p = 0.001). No significant differences were found in 30-day mortality (p = 0.521). At one-year, functional outcomes assessed by the modified Rankin Scale showed no significant difference (p = 0.899). Complete aneurysm occlusion and recurrence rates were also comparable between groups. Conclusions: Both approaches provide effective treatment for unruptured aneurysms with favorable long-term outcomes. The pterional approach is associated with increased muscle-related complications, whereas the supraorbital approach carries higher risks of intraoperative complications and olfactory dysfunction. Tailoring the surgical approach based on patient and aneurysm characteristics remains essential. Full article
(This article belongs to the Special Issue Advances in the Diagnosis, Visualization and Treatment of Intracranial Aneurysms and Subarachnoid Hemorrhage)
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14 pages, 1585 KB  
Article
Management and Outcomes of Multiple Unruptured Cerebral Aneurysms: A Descriptive Cohort Analysis
by Oday Atallah, Khadeja Alrefaie and Amr Badary
Brain Sci. 2025, 15(9), 973; https://doi.org/10.3390/brainsci15090973 - 10 Sep 2025
Viewed by 1368
Abstract
Background: Unruptured cerebral aneurysms pose a significant neurosurgical challenge due to their potential for rupture, which can lead to devastating subarachnoid hemorrhage. Advances in imaging have increased incidental detection of multiple unruptured aneurysms, necessitating tailored management strategies to balance rupture risk against treatment [...] Read more.
Background: Unruptured cerebral aneurysms pose a significant neurosurgical challenge due to their potential for rupture, which can lead to devastating subarachnoid hemorrhage. Advances in imaging have increased incidental detection of multiple unruptured aneurysms, necessitating tailored management strategies to balance rupture risk against treatment complications. Methods: We retrospectively analyzed 41 patients with 101 unruptured cerebral aneurysms, assessing demographics, aneurysm size and location, treatment modalities, and clinical outcomes. Descriptive statistics and correlation analyses examined associations between aneurysm characteristics, comorbidities, and post-treatment complications. Results: Most aneurysms were small (<10 mm, 48.5%), primarily located at the Middle Cerebral Artery Bifurcation (27.7%). Hypertension (56.1%) and smoking (53.7%) were prevalent risk factors. Clipping was the most common intervention (81.2%), with 41.4% of patients experiencing post-operative complications and 36.6% developing neurological deficits. Conclusions: This study underscores the difficulties in managing multiple unruptured cerebral aneurysms owing to diverse aneurysm characteristics and patient risk factors such as hypertension, hyperlipidaemia, and smoking. Clipping was the predominant intervention, with time customized for each individual case. Despite the occurrence of problems such as vasospasm and neurological difficulties, the majority of patients maintained functional independence. The results provide significant insights into the clinical attributes, therapeutic strategies, and outcomes for this patient cohort. Full article
(This article belongs to the Special Issue Advances in the Diagnosis, Visualization and Treatment of Intracranial Aneurysms and Subarachnoid Hemorrhage)
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18 pages, 4222 KB  
Systematic Review
The Safety and Efficacy of Glibenclamide in Managing Cerebral Edema After Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis
by Majd M. AlBarakat, Rana B. Altawalbeh, Khaled Mohamed Hamam, Ahmed A. Lashin, Ahmed Wadaa-Allah, Ayah J. Alkrarha, Mohamed Abuelazm and James Robert Brašić
Brain Sci. 2025, 15(7), 677; https://doi.org/10.3390/brainsci15070677 - 24 Jun 2025
Viewed by 1793
Abstract
Background/Objectives: We sought to determine if glibenclamide, a sulfonylurea receptor 1-transient receptor potential melastatin 4 (SUR1-TRPM4) channel blocker, reduces cerebral edema and improves neurological functioning in aneurysmal subarachnoid hemorrhage (aSAH). Methods: Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a [...] Read more.
Background/Objectives: We sought to determine if glibenclamide, a sulfonylurea receptor 1-transient receptor potential melastatin 4 (SUR1-TRPM4) channel blocker, reduces cerebral edema and improves neurological functioning in aneurysmal subarachnoid hemorrhage (aSAH). Methods: Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was conducted in PubMed, Cochrane Library, Web of Science, and SCOPUS for studies evaluating glibenclamide in aSAH patients. Primary outcomes included scores on the modified Rankin Scale (mRS) at discharge and the Subarachnoid Hemorrhage Early Brain Edema Score (SEBES) at ten days post-intervention. Secondary outcomes included adverse events, and safety and efficacy endpoints. Random-effects models were employed for meta-analyses. Results: Three studies utilizing oral glibenclamide (n = 245) met inclusion criteria. Oral glibenclamide demonstrated no significant improvements in mRS scores [MD −0.19 with 95% CI (−2.05, 1.66)] at discharge, [MD 0.06, (−0.60, 0.71)] at 3 months, and [MD 0.4, (−0.67, 0.87)] at 6 months; functional independence [risk ratio (RR) 1.05, (0.81, 1.36)]; independent ambulation [RR 1.07, (0.77, 1.48)]; mortality [RR 0.79, (0.42, 1.50)]; or delayed cerebral ischemia [RR 0.58, (0.31, 1.09]). Hypoglycemia risk was significantly higher in the glibenclamide group [RR 3.92, (1.14, 13.49)]. Conclusions: Oral glibenclamide offers a novel approach to addressing cerebral edema in aSAH but shows limited clinical efficacy in improving functional and neurological outcomes in subtherapeutic doses. Its safety profile is acceptable, though hypoglycemia risk necessitates careful monitoring. Further research is required to optimize dosing, timing of intervention, and patient selection to enhance therapeutic outcomes. By contrast, intravenous administration of therapeutic doses of glibenclamide offers a promising avenue for future studies in the management of aSAH by taking advantage of the favorable pharmacokinetics of this route of administration. Full article
(This article belongs to the Special Issue Advances in the Diagnosis, Visualization and Treatment of Intracranial Aneurysms and Subarachnoid Hemorrhage)
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