Zusammenfassung
Die operative Behandlung der sackförmigen Aneurysmen der Hirngefäße hat sich innerhalb der neurochirurgischen Behandlungsmethoden zunächst nur sehr zögernd und langsam entwickelt. Dieses lag weniger an der technischen Unzulänglichkeit des operativen Vorgehens, sondern war in der Tatsache begründet, daß allgemein derartige Eingriffe für zu riskant und wenig erfolgversprechend galten. Selbst die Entwicklung der cerebralen Angiographie, welche die genaue Diagnose dieser Erkrankung erst möglich machte, konnte die operative Behandlung zunächst nur wenig beeinflussen bzw. vorantreiben. So galt zu der Zeit, als bereits die Chirurgie der raumfordernden Prozesse des Gehirns durch Cushing, Bailey, Dandy, Olivecrona u. Tönnis erfolgreich betrieben wurde, die Operation eines sackförmigen Aneurysmas als selten durchgeführtes Wagnis mit meist ungünstigem Ausgang für den Patienten. Manche Stimmen (Küttner 1936) hielten eine derartige operative Behandlung des sackförmigen Aneurysmas kaum jemals für möglich. Wenigen Beobachtungen über erfolgreich operierte Fälle stand die Skepsis der meisten Neurochirurgen gegenüber, auch die sackförmigen Aneurysmen zum Gegenstand der neurochirurgischen Behandlung werden zu lassen (Dandy). Aus der Tatsache, daß man den wiederholt blutenden sackförmigen Aneurysmen — häufig mit tödlichem Ausgang — bei konservativem Abwarten praktisch hilflos gegenüberstand, entwickelte sich zunächst die Behandlung durch die Ligatur der A. carotis am Halse, in der Vorstellung, hierdurch einen Einfluß auf die Blutung zu gewinnen und eventuell das Aneurysma zur Thrombo-sierung zu bringen.
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Tönnis, W., Walter, W. (1966). Die Behandlung der sackförmigen intrakraniellen Aneurysmen. In: Lange-Cosack, H., Norlén, G., Tönnis, W., Walter, W. (eds) Klinik und Behandlung der Raumbeengenden Intrakraniellen Prozesse II. Klinik und Behandlung der Raumbeengenden Intrakraniellen Prozesse, vol 4 / 2. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-87177-1_3
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