Cerebrovascular Surgeries

Clipping is a surgery performed to treat an aneurysm. An aneurysm is a balloon-like bulge or weakening of an artery wall. As an aneurysm grows, it can become so thin that it leaks or ruptures, releasing blood into the spaces around the brain. This bleeding is life-threatening. A neurosurgeon opens the skull and places a tiny clip across the neck of the aneurysm to stop or prevent an aneurysm from bleeding.

Embolization is a minimally invasive procedure to treat an aneurysm by filling it with material that closes off the sac. This reduces the risk of rupturing or rebleeding. It is performed from within the artery through a steerable catheter inserted into the blood stream at the groin and guided to the brain. Tiny coils, glue or mesh stents are used to promote clotting and close off the aneurysm.

An arteriovenous malformation (AVM) is an abnormal tangle of blood vessels in the brain or spine. They connect directly to veins and cause the vessels to stretch and sometimes rupture. Symptoms include stroke, seizures, headache and other problems. Treatment options include surgery, embolization and radiosurgery.

Carotid stenosis, also called carotid artery disease, is a narrowing of the carotid arteries. Carotid arteries are the two major arteries that carry oxygen-rich blood from the heart to the brain. Stenosis is caused by a build-up of plaque inside the artery wall. This reduces blood flow to the brain. There are often no symptoms until the artery becomes severely narrowed or a clot forms. Symptoms are likely to first appear with a mini-stroke.

Treatment aims to reduce the risk of stroke by controlling or removing the plaque and preventing blood clots. Surgery is often an option for patients who have suffered one or more strokes or who have a moderate to high grade of stenosis. Surgery involves removing or reducing plaque build-up and enlarging the artery to let more blood flow to the brain.

Cerebral bypass surgery is performed to restore blood flow to the brain. A cerebral bypass is the brain's equivalent of a coronary bypass in the heart. The surgery connects a blood vessel from outside the brain to a vessel inside the brain to reroute blood flow around a damaged or blocked artery. The goal of bypass surgery is to restore blood supply to the brain and prevent strokes.

A craniotomy is a surgery to cut a bony opening in the skull. A section of the skull, called a bone flap, is removed to access the brain underneath. The bone flap is usually replaced with tiny plates and screws. A craniotomy may be small or large, depending on the problem. It may be performed to treat tumors, hematomas, aneurysms, AVMs, skull fractures, foreign objects, swelling of the brain or infection.

Intracerebral hemorrhage (ICH) is caused by bleeding within the brain tissue itself. This is a life-threatening type of stroke. A stroke occurs when the brain is deprived of oxygen and blood supply. ICH is most commonly caused by hypertension, arteriovenous malformations or head trauma. Once the cause and location of the bleeding is known, medical or surgical treatment is performed. Treatment focuses on stopping the bleeding, removing the blood clot and relieving the pressure on the brain.

Intracranial stenosis is a narrowing of an artery inside the brain. A build-up of plaque inside the artery wall reduces blood flow to the brain. When build-up is severe enough to cause symptoms, it carries a high risk of stroke and can lead to brain damage and death. Treatments aim to reduce the risk of stroke by controlling or removing plaque buildup and by preventing blood clots.

Moyamoya disease is caused by blocked arteries at the base of the brain. The word "moyamoya" means "puff of smoke" in Japanese. It describes the appearance of tiny vessels that form because of the blockage. As the normal blood vessels narrow and become blocked, a person may suffer a stroke. No medication can stop or reverse the progression of moyamoya disease. Treatment focuses on reducing the risk of stroke and restoring blood flow to the brain. Surgery is an option in certain cases. Several different kinds of surgeries are available, all with the goal of preventing further strokes by restoring blood flow to the brain.

Stroke is an emergency! When symptoms appear, call 911 immediately. Every minute counts. A stroke occurs when the brain is deprived of oxygen and blood supply. A person may have problems speaking, walking, seeing or thinking. It may result in permanent brain damage or death. If the stroke is caused by a blood clot, a clot-busting drug or retrieval device may be used to restore blood flow. In certain cases, surgery is needed.

Subarachnoid hemorrhage (SAH) is a life-threatening type of stroke caused by bleeding into the space surrounding the brain. SAH can be caused by a ruptured aneurysm, AVM or head injury. Vasospasm can occur as a result and can happen several days after an SAH. Vasospasm is when an artery clamps down because leaked blood touches it. It can descrease blood needed in other parts of the brain. It can be fatal.

Treatment for SAH varies, depending on the cause and extent of brain damage. It may include medication and/or surgery. Treatment focuses on stopping the bleeding, restoring normal blood flow and preventing vasospasm.