World Neurosurg
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Classic three-dimensional schemas of the internal carotid artery (ICA) for transcranial approaches do not necessarily apply to two-dimensional endoscopic views. Modifying an existing ICA segment classification, we define endoscopic orientation for the lacerum (C3) to clinoid (C5) segments through an endonasal approach. ⋯ Distinguishing which ICA type courses between the lacerum and clinoid segments can help clarify the relationships between the artery and its surrounding structures during endoscopic approaches. Adapting the classic terminology of ICA segments provided consistency of endoscopic relevance, defined potential endoscopic corridors, and highlighted the critical step of arterial contact.
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To focus on postoperative drawings of aneurysms, which serve as visual records and teaching tools for neurosurgeons and reinforce three-dimensional vascular configurations that are specific for different cerebral aneurysms, and examine experience with this technique, particularly in regard to the training of neurosurgical residents. ⋯ Creation and review of postoperative drawings are important adjuncts for the development of three-dimensional understanding of aneurysmal anatomy. This classic art has impact in the digital age and allows patterns of morphology, projection, and anatomy to be reinforced. Surgical atlases created from postoperative drawings function as reference and teaching tools. The creation of postoperative drawings should be a routine part of the training and methodology of vascular neurosurgeons.