Advances in Cerebral Aneurysm Surgery: The Latest Technologies and Techniques

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

Deadline for manuscript submissions: 20 February 2026 | Viewed by 552

Special Issue Editor


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Guest Editor
Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University Linz, Wagner-Jauregg-Weg 15, A-4020 Linz, Austria
Interests: aneurysm; spinal surgery; tumour surgery; vascular surgery; surgery for epilepsy; paediatric neurosurgery; radiosurgery; functional neurosurgery

Special Issue Information

Dear Colleagues,

Cerebral aneurysms are treated by reconstructive (i.e., surgical clipping, endosaccular coiling, stent-assisted coiling, flow-diversion) and deconstructive (i.e. parent artery occlusion with or without protective bypass surgery) techniques. To remain among a first-line treatment option, the therapeutic procedure of microneurosurgical aneurysm clipping requires permanent refinements, including technical advances in operation planning and simulation, improvements in intraoperative monitoring and imaging, microneurosurgical high-end wet-lab trainings, and the mastering of cerebral bypass surgery as a firstline treatment as well as a bail-out procedure. Hybrid neurovascular surgery in expert hands is a promising strategy and will enhance patient safety by merging surgical and endovascular techniques in one procedure. Aneurysm rupture analysis using fluid structure interactions in vivo, in vitro, and in virtual simulations will add to our understanding of which aneurysms require active surgical treatment. The scope of this Special Issue is therefore the discussion of current and future strategies to improve procedural safety, angiographic results, and clinical outcomes in patients suffering from both ruptured and unruptured cerebral aneurysms. We therefore call for papers on the microsurgical treatment of cerebral aneurysms, with a special focus on clinical research, preoperative planning and simulation, skills-lab training, and hybrid neurosurgical concepts.

Prof. Dr. Andreas Gruber
Guest Editor

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Keywords

  • microsurgical aneurysm clipping
  • preoperative simulation
  • hybrid neurovascular surgery
  • skills-lab training
  • intraoperative monitoring and imaging

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Published Papers (1 paper)

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Research

14 pages, 835 KB  
Article
Infarct Timing and Predictors of Infarct-Free Survival in Patients with Aneurysmal Subarachnoid Hemorrhage
by Pikria Ketelauri, Meltem Gümüs, Aigerim Togyzbayeva, Hanah Hadice Karadachi, Anna Michel, Emad Mohajerani, Christoph Rieß, Thiemo Florin Dinger, Laurèl Rauschenbach, Marvin Darkwah Oppong, Yahya Ahmadipour, Philipp Dammann, Ulrich Sure and Ramazan Jabbarli
Brain Sci. 2025, 15(10), 1042; https://doi.org/10.3390/brainsci15101042 - 25 Sep 2025
Viewed by 368
Abstract
Background/Objectives: Cerebral infarction significantly worsens outcomes after aneurysmal subarachnoid hemorrhage (SAH). This retrospective study analyzed early predictors of infarct-free survival and the impact of infarct timing on clinical outcomes. Methods: We reviewed 988 consecutive SAH patients treated from 2003 to 2016, all with [...] Read more.
Background/Objectives: Cerebral infarction significantly worsens outcomes after aneurysmal subarachnoid hemorrhage (SAH). This retrospective study analyzed early predictors of infarct-free survival and the impact of infarct timing on clinical outcomes. Methods: We reviewed 988 consecutive SAH patients treated from 2003 to 2016, all with follow-up CT scans. Baseline clinical and SAH characteristics were recorded to identify predictors of infarct-free survival and assess the relationship between infarct timing and outcomes. Results: Cerebral infarctions occurred in 475 patients (48.1%) at a median of 3.4 days post-SAH; 70.9% happened within the first week. Earlier infarctions were associated with higher in-hospital mortality (odds ratio [OR] = 0.91 per day increase, p < 0.0001) and poor 6-month outcomes (modified Rankin Scale > 3; OR = 0.96 per day increase, p = 0.012), especially within 48 h. Independent predictors of infarct-free survival included poor initial condition (WFNS ≥ 4, adjusted hazard ratio [aHR] = 1.82, p < 0.0001), intraventricular hemorrhage (aHR = 1.25, p = 0.041), aneurysm rebleeding (aHR = 1.76, p < 0.0001), acute hydrocephalus (aHR = 1.38, p = 0.020), and daily aspirin intake (aHR = 0.68, p = 0.002). The number of baseline risk factors (0–5) strongly influenced both infarction likelihood and timing (p < 0.0001). Conclusions: Cerebral infarctions predominantly occur within the first week after SAH, with earlier infarctions having a more severe impact on outcomes. Initial risk factor-adapted SAH management may improve functional outcomes. Full article
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