Summary

Although technical advances in the surgical management of aneurysms are limited, microsurgery can still be used to create elegant and anatomical bypasses in the hands of a skilled neurosurgeon. The evolving trends in the field include more minimally invasive approaches; more use of direct clipping, clip reconstruction, and bypass procedures; and less brain retraction and skull base surgery. Circulatory arrest as part of the aneurysm surgical process is no longer used.