What is vascular neurosurgery?

Vascular neurosurgery is a complex subspecialty that treats injuries related to haemorrhages or strokes in the brain or spinal cord. It is a very complex subspecialty, due to high technical requirements, and the effects that these conditions can have on the life and function of the patient.

In general, vascular neurosurgery covers arterial aneurysms, vascular malformations and dural arteriovenous fistulas. It also treats cavernomas, which are midway between vascular and tumoural lesions, and some diseases that can cause cerebral infarctions. Here is a brief summary of some of the conditions treated by vascular neurosurgery:

Cerebral aneurysms

A cerebral aneurysm (also known as an intracranial or intracerebral aneurysm) is a weak or thin spot on a blood vessel in the brain that swells as it fills with blood. They can be diagnosed by chance in the course of a study for another condition or be symptomatic. When symptomatic, they should be treated either by microsurgery or by endovascular treatment. The aim is to remove the aneurysm entirely from circulation. For asymptomatic ones, due to the risk of rupture, those that have demonstrated growth or that are irregular should be treated. It is imperative that a cerebral aneurysm is evaluated by a neurosurgeon with extensive experience.

Arteriovenous malformations

Most are diagnosed after bleeding occurs. In these cases, it is essential that the patient is treated by a very experienced neurosurgeon, since the surgical treatment of cerebral and spinal malformations is possibly the most complicated in neurosurgery. The most appropriate treatment will depend on the malformation’s location and size and the age of the patient.

Arteriovenous fistulas

Depending on the location (cranial / spinal), a surgical or endovascular treatment can be performed for ductus types. The arteriovenous fistulas in the spine are usually best resolved through surgery.

Cavernomas

Cluster of irregular blood vessels, usually found in the brain and spinal cord. They are treated using surgery.