Samson D, Batjer HH, White J, et al. Intracranial Aneurysm Surgery: Basic Principles and Techniques. Thieme 2011, 219 pages, 159 illustrations, $74.99.
Intracranial Aneurysm Surgery: Basic Principles and Techniques is written by one of the modern day icons of cerebrovascular surgery and his colleagues. The book is a concise, step-by-step, how-to cookbook based on Dr. Sampson’s wealth of knowledge and vast clinical experience at UT southwestern. There are no major articles quoted or new data presented, only references to his peers that are as recognized as he is. This handbook is mainly geared towards the senior neurosurgical resident or cerebrovascular fellow starting out their vascular subspecialty. It is also a wonderful refresher for seasoned vascular surgeons who want to learn some tricks of the trade from one of the masters.
The book is written in a candid and rather comical manner, which brings through the authors personality and no nonsense frankness. What you get in this book is pure practical information with the fat cut out. The book starts with the authors’ philosophy on cerebrovascular surgery and the mindset and training of a vascular surgeon. It soon explores the basics of structuring a practice and building a team to support a vascular practice including: detailed recommendations about the operating room setup, equipment, task allocation to supporting staff, and general guidelines for the anesthesia team. It also paints a picture of the ideal operating room conditions, which is critical when disaster strikes during a case. This part of the book contains great advice for surgeons in any stage of practice wanting to optimize the function of their operating rooms.
Once the authors set up the stage for the ideal operating theater and the actors involved, they then delve into the intricacies of treating aneurysms. The book is divided into chapters that address aneurysms in particular vascular territories (e.g., proximal carotid aneurysm, vertebro basilar aneurysms, etc.). These chapters are then divided into sections that deal with the anatomy of the vascular tree and the nuances of each type of aneurysm. These nuances include size, projections, and relation of critical surrounding vessels. The chapter then goes on to discuss the practical aspect of surgery, including positioning of the patient and how to tailor the craniotomy in relation to location of the aneurysm. Next, the subtleties of microsurgery are explained step by step, including the initial approach, obtaining proximal control, exposure of the aneurysm, and clip placement or reconstruction. These technical explanations are intermingled with words of caution and pitfalls to avoid. There are also very informative tips and tricks to get you out of trouble. The book is well illustrated with hand drawings that are in black-and-white but are clearly labeled and easily convey the message of the supporting text. Each chapter is finished with “final thoughts” that are pearls of wisdom you get only from a master surgeon. The book is very well organized and stays true to its organization as it goes through all of the major types of aneurysms one may encounter.
Overall the book is a great, quick read that provides concise information on the technical aspects of cerebrovascular surgery backed up with relevant hand drawings. It is a candid, personal book written by a great teacher of cerebrovascular surgery. However, its primary audience is the young cerebrovascular surgeon. Its relevance to a radiology audience may be questionable, unless you are an endovascular interventionalist that wants to understand the nuances of the other side of the vessel.
