Vascular
Neurosurgery
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Vascular
Neurosurgery on WebMD |
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Aneurysms
of blood vessels in the brain are a fairly common problem.
In fact, approximately ten percent of people may have
aneurysms that do not cause any symptoms at all. However,
an aneurysm can rupture and cause bleeding in the brain.
Once discovered, an aneurysm usually is treated to prevent
further bleeding over time. The aneurysm is a small area
on a blood vessel where there has been a weakening that
slowly enlarges over time and can rupture.
For
most aneurysms, the treatment of choice is surgery to
expose the aneurysm and place a small metallic clip
across the base of the aneurysm to completely occlude
it. This prevents further risk of bleeding. The patient
is in the hospital for aggressive postoperative treatment
if they have had an aneurysm rupture. This is designed
to prevent any further problems such as spasm of blood
vessels which can occur after bleeding has taken place.
Here
at St. Francis Hospital we have a very high level of
sophistication in treating patients both surgically
and postoperatively when an aneurysm has ruptured. Certain
patients, because of extremes of age or poor medical
condition, may not be good surgical candidates. In this
situation, patients may potentially benefit from endovascular
placement of coils into the aneurysm to obliterate it.
This is done in the angiography department by the neuroradiologist.
Small metal coils are placed inside the aneurysm via
the feeding blood vessel through a small catheter. The
coils then allow blood to clot inside the aneurysm,
protecting it from bleeding. Although this procedure
is relatively new, it does show good promise for the
treatment of patients who are not good surgical candidates.
This procedure is offered only at very few centers throughout
the country.
Finally,
the neurosurgeon is occasionally faced with treatment
of an arteriovenous malformation in the brain. This
is a small tangle of blood vessels which are leaky because
of their abnormal development. This is a congenital
problem which can present with bleeding in the brain.
Some
arteriovenous malformations are treated with surgery
to remove them which can be accomplished safely if they
are in a safe location in the brain. Other arteriovenous
malformations can potentially be treated with radiation
therapy, depending on their size and location.
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