Mayfield and Drake<unk>  clips ready for implantation. Emergency treatment for individuals with a ruptured cerebral<unk>  generally includes restoring deteriorating respiration and reducing intracranial pressure. Currently there are two treatment options for securing<unk> s: surgical clipping or endovascular coiling. If possible, either surgical clipping or endovascular coiling is typically performed within the first 24 hours after bleeding to occlude the ruptured<unk>  and reduce the risk of recurrent hemorrhage. While a large meta-analysis found the outcomes and risks of surgical clipping and endovascular coiling to be statistically similar, no consensus has been reached. In particular, the large randomised control trial International Subarachnoid<unk>  Trial appears to indicate a higher rate of recurrence when intracerebral<unk> s are treated using endovascular coiling. Analysis of data from this trial has indicated a 7% lower eight-year mortality rate with coiling, a high rate of<unk>  recurrence in<unk> s treated with coiling—from 28.6–33.6% within a year, a 6.9 times greater rate of late retreatment for coiled<unk> s, and a rate of rebleeding 8 times higher than surgically-clipped<unk> s. Surgical clipping<unk> s can be treated by clipping the base of the<unk>  with a specially-designed clip. Whilst this is typically carried out by craniotomy, a new endoscopic endonasal approach is being trialled. Surgical clipping was introduced by Walter Dandy of the Johns Hopkins Hospital in 1937. After clipping, a catheter angiogram or CTA can be performed to confirm complete clipping. Endovascular coiling Endovascular coiling refers to the insertion of platinum coils into the<unk> . A catheter is inserted into a blood vessel, typically the femoral artery, and passed through blood vessels into the cerebral circulation and the<unk> . Coils are pushed into the<unk> , or released into the blood stream ahead of the<unk> . Upon depositing within the<unk> , the coils expand and initiate a thrombotic reaction within the<unk> . If successful, this prevents further bleeding from the<unk> . In the case of broad-based<unk> s, a stent may be passed first into the parent artery to serve as a scaffold for the coils. Cerebral bypass surgery Cerebral bypass surgery was developed in the 1960s in Switzerland by Gazi Yasargil. When a patient has an<unk>  involving a blood vessel or a tumor at the base of the skull wrapping around a blood vessel, surgeons eliminate the problem vessel by replacing it with an artery from another part of the body.
Intracranial aneurysm
Infectious intracranial aneurysm
Subarachnoid hemorrhage
Cerebral vasculitis
Cerebral atherosclerosis
Cerebral infarction
Intracranial hemorrhage
Carotid artery dissection