Microvascular & Endovascular Surgery

The vascular neurosurgeon specializes in surgeries at the micro-level, treating and repairing malformed or injured blood vessels deep within the vital structures of the brain and spine. These neurosurgeons are highly skilled & specialized clinicians that work to keep the central nervous system functioning properly by treating the blood vessels that supply the spinal cord and brain with a rich oxygenated blood supply.

When problems with the blood vessels and the spine occur, the possibility for complications is potentially very high. The brain and spine are incredibly delicate, filled with a network of blood vessels that, when blocked or damaged, can cause massive problems with the entire body. One problem with blood flow or the blood vessels can impair nervous system function forever, causing disability and potentially life-threatening illness.

Vascular surgeons treat neurovascular disorders, which are also called cerebrovascular conditions. These illnesses occur within the body’s blood vessels. The most common disorders include:

• Cerebral aneurysms: a balloon-like bulge in the artery wall within the brain which bleeds following a rupture
• Arteriovenous malformations (AVMs): an abnormal tangle of blood vessels within the brain or spine that can prevent normal blood flow or bleeds
• Arteriovenous fistulas (AV fistula): an abnormal connection between an artery and a vein that disrupts normal blood flow
• Cavernous malformation: Vascular abnormality which forms a walled cavity filled with blood which is collected gradually within
• Moyamoya disease: A condition where the major arteries of brain gradually start shrinking and then get obliterated, usually on both sides
• Carotid artery disease (CAD): The blood vessels of the brain get narrowed of blocked by a clot due to the accumulation of cholesterol forming a plaque within.

All of these disorders could be life-threatening or benign, depending on their severity. However, typically, anytime a disruption with your blood vessels or blood flow occurs, it means parts of your brain or spine can’t get the nutrients and oxygen you need. This can quickly escalate into a life-threatening problem.

A vascular neurosurgeon can help with medication, surgery, microsurgical clipping, which places a metal clip across an aneurysm or AVM to stop bleeding—and more.

The decision to clinically intervene in these cases rests upon a number of tests that include diagnostic imaging to look at the shape, size, and location of the problem. Technology plays a huge role in the vascular neurosurgery profession. They use a microscope and very small sutures or clips to treat these abnormalities of the brain and spine. When we do open surgical procedures, our goal is to preserve the normal blood vessels and remove whatever is abnormal, whether it is an aneurysm, an AVM, or an AV fistula. Sometime in diseases like moyamoya, bypass of the arteries, small to large, is required.

Patients can experience the sudden onset of serious symptoms such as:

• Vision problems such as the loss of vision in one or both eyes
• Severe and sudden headaches with no known cause
• Balance and coordination problems
• Seizures or fainting
• Motor problems including trouble walking or grasping something with your hands.
• One-sided muscle weakness, numbness, or paralysis
• Difficulty speaking or understanding what people are saying
• Behavioral or personality changes
• Nausea and vomiting unrelated to other illness
• Mini-strokes, known as transient ischemic attacks (TIAs)

Even if these symptoms are mild or temporary, it’s important to contact your doctor immediately.