The Department of Neurosurgery offers the complete range of treatments for vascular disorders that affect the brain and spinal cord, including aneurysms (thin-walled, balloon-like areas in blood vessels), arteriovenous malformations or AVMs (defects of the arteries and veins), strokes, and tumors of the blood or lymph vessels.
One component of the Department of Neurosurgery is the bimonthly Neurovascular Conference. A comprehensive specialty team of neurosurgeons, radiologists, neurologists, and neuroradiologists review individual patient cases and provide recommendations on the most optimal treatment alternatives. The Neurovascular Conference provides unparalleled expertise, allowing physicians to consult with a variety of specialists in one setting.
Bleeding from a brain aneurysm is a life-threatening emergency, requiring complex medical and surgical skills to increase the chances of recovery. About 10 million people have a brain aneurysm in the United States each year, and about 15,000 people die from their aneurysms. Neurosurgeons (physicians who specialize in surgery of the nervous system) at the Institute are specialists in the surgical treatment of aneurysms. The most common treatment is clipping, which involves placing a small clip on the neck of the aneurysm to remove the risk of bleeding. Some patients are best treated by endovascular (within a vessel) surgery, which involves placing metal coils directly into the aneurysm. Our team is also very experienced in screening patients at high risk for brain aneurysms before they cause any symptoms. Visit Frequently Asked Questions about Brain Aneurysms for more information.
Arteriovenous malformations (AVMs) are defects of the arteries and veins that can cause seizures, small strokes or bleeding in the brain. The Department of Neurosurgery uses a variety of methods to treat AVMs, including microsurgery (microscope-aided surgery on a very small area), endovascular (within a vessel) surgery and radiosurgery (surgery that uses radiation).
Microsurgery is used to completely remove the AVM. Radiosurgery uses radiation to scar down the AVM over several years. In many patients these treatments are combined with endovascular surgery, which fills the AVM with metal coils, glue or small particles to decrease the blood supply to the AVM.
Strokes can be treated with surgery or with clot-busting drugs. An expert team of neurologists (specialists in the nervous system), neurosurgeons, neuroradiologists (physicians who specialize in radiation therapy for disorders of the nervous system) and physiatrists (physicians who specialize in using physical treatments, such as temperature, light, water, electricity and exercise) work together to manage stroke patients, ensuring the best treatment for every patient's individual condition. To prevent stroke, some patients with narrowed or blocked arteries may need revascularization, a process that uses a vein from another part of the body to bring a new blood supply to the brain.
Moya-moya is a rare disorder of uncertain cause that leads to irreversible blockage of the main blood vessels to the brain as they enter the skull. The name comes from the Japanese and means "puff of smoke," which describes the appearance of the lesion on an angiogram. This is a lesion that tends to affect children and adults in the third to fourth decades of life. In children it tends to cause strokes or seizures, while adults experience bleeding or strokes. The repeated strokes can lead to severe functional impairment or even death so that it is important to diagnose and treat the condition early on and the neurosurgeons at the Department of Neurosurgery have extensive experience treating the condition.
A CT or MRI may diagnose the presence of moya-moya, but an angiogram is usually used to confirm the diagnosis and to determine the anatomy of the vessels involved. Often nuclear medicine studies such as SPECT (single photon emission computerized tomography) are used to demonstrate the decreased blood and oxygen supply to areas of the brain involved with the Moya-moya disease. Surgical intervention is the most favored treatment, designed to allow the development of new means of bringing blood to the brain and to bypass the blockage. The risks involved in the surgeries are low and the long-term outlook for children with treated moya-moya is good. While symptoms may seem to improve almost immediately after surgery, it will usually takes 6-12 months before new vessels can develop sufficiently. Once major strokes or bleeding occurs, however, even with treatment, the patient may be left with permanent loss of function so it is important to treat this condition promptly.
The surgeons at the department have extensive experience in the treatment of cavernous malformation, which occurs when a blood-filled mass resembling a tumor, called a hemangioma, forms. Symptoms include headaches and seizures, and the disease appears to be frequently inherited. The neurosurgeons at the Department of Neurosurgery are experienced in treating cavernous malformations. Surgery may be performed if the malformation is easily accessible and is causing seizures or bleeding in the brain, although cavernous malformation is not always life-threatening and often does not require any specific treatment. After surgery, patients generally improve, some quite significantly.
For an appointment, a second opinion or more information, please call 1-800-CEDARS-1 (1-800-233-2771) or e-mail us.
