Clip exclusion of anterior circulation aneurysms: a surgical atlas

This book is mainly addressed to young neurosurgeons, or rather to vascular neurosurgeons in training. The aim of the book is to illustrate the surgical experience of the senior author (AP) in a simple and didactic way, based on extensive illustrations of each case presented. This has been achieved through the close collaboration and friendship between two neurosurgeons, the senior author and a gifted artist (VV). For each case, there are two types of illustrations: conceptual colored pictures before and after aneurysm clipping (which represent the artist’s idea, in which particular items may be slightly different from reality) and schematic black and white drawings corresponding strictly to the accompanying video. An additional type of colored pictures represents the artist’s view of the aneurysmal morphology and pertinent vascular architecture, mainly resulting from the preoperative imaging (CT scan and/or angiography); this “introductory” illustration helps the reader to understand the anatomical situation before accessing the video presentation. Each video presentation – roughly 2 minutes long – is intended to illustrate a step by step approach to the aneurysm; the interpretation of the video is facilitated by a parallel text where the surgical stages are progressively presented. 

This atlas presents only aneurysms of the anterior circulation, since the results of endovascular management for posterior circulation aneurysms are now – in most centers – definitely better than the surgical results. 

The passion for anatomical drawing began in the 1970s when, as a young student at Rome’s La Sapienza University, VV was fascinated by the wonderful architecture of the inner ear; he is indebted to his father, the neurologist Francesco Valente, for his love of neuroanatomy, and to his art teacher, Giuseppe Allevato, for the basic techniques of shading and perspective. 

A lead pencil, some colored pencils and Indian ink are the only tools used: anatomical drawings created with traditional techniques in this age of computerisation and perfect virtual images could be considered an old-fashioned and obsolete exercise. However, by not using graphics software, the drawings aim to transmit not only technical-scientific knowledge, but also the emotions of the long road of human experience. 

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