Aneurysm, Cerbro-vascular
Arterio-venous Malformation
An arteriovenous malformation (AVM) is an abnormal tangle of arteries and veins. This condition can occur anywhere in the central nervous system and causes blood to flow directly from arteries to veins through an abnormal passageway called a fistula.
Treatments for Artrio-venous Malformation
Treatment depends on the size, location, and symptoms of the arteriovenous malformation. Your doctor may recommend one or a combination of the following treatments
Surgery – The arteriovenous malformation is removed from the brain using microsurgical techniques that close the abnormal feeding arteries, separate the tangle from the adjacent brain, and cut the veins draining the AVM.
Endovascular embolization – In this minimally invasive technique, a catheter is guided through the network of arteries until the tip reaches the site of the AVM. Various branches of the AVM are then plugged with a material such as glue or polymer cast. Embolization is usually used as a precursor to surgery to reduce the blood flow through the AVM.
Radiosurgery – In this noninvasive procedure, focused beams of radiation are targeted at the AVM and, over the course of 2-3 years, the arteries respond by scarring and closing down. Radiosurgery can be curative or can shrink an AVM down to a size that is more favorable for surgery.
Symptoms of Artrio-venous Malformation
- Seizures, Headaches
- Muscle weakness or paralysis
- Problems with balance and coordination (ataxia)
- Pain or tingling or numbness over body
- Loss of vision in one or both eyes
- Deviated eye balls
- Problems understanding language (aphasia)
- Dizziness, Memory deficits
- Memory deficits
- Mental confusion, hallucinations, or dementia
How are Artrio-venous Malformation diagnosed?
- Imaging tests, such as computed tomography (CT)
- Magnetic resonance imaging (MRI) scans
Aneurysm, Cerbro-vascular
Brain Aneurysm
A brain aneurysm, also called a cerebral aneurysm, is a weak point along a wall of blood vessels in the brain that pouches outward.
Often described as balloon-like appearance, these aneurysms may burst and bleed into the brain (hemorrhage, or hemorrhagic stroke).
This can potentially cause life-threatening complications.
Even if a brain aneurysm does not burst and bleed, it can cause other problems by putting pressure on nerves or brain tissue due to their large size. Most cerebral aneurysms occur along arteries at the base of the brain known as the circle of Willis.
Treatments for Brain Aneurysm
When deciding whether or not to treat an unruptured brain aneurysm, your doctor will consider many factors.
Microvascular clipping is a surgical procedure that involves cutting off blood flow to the brain aneurysm. Your neurosurgeon will open up part of your skull and place a clip on the neck of the aneurysm to stop its blood supply. This will eventually lead to collapse and fibrosis of aneurysm.
Occlusion is a procedure where your neurosurgeon clamps off the entire artery harbouring aneurysm. This surgery is often performed when an aneurysm is not clippable.
Endovascular embolization is a treatment similar to cardiac angioplasty where a catheter is inserted into a major artery and advanced through the artery to reach the brain aneurysm. Coils are passed through the catheter and then released into the aneurysm. The coils then fill the aneurysm, blocking the inflow of blood and causing it to clot. This decreases the chances of rupture.
Symptoms of Brain Aneurysm
- Sudden, severe headache called a thunderstorm headache.
- Double vision
- Drooping eyelid
- Nausea, Vomiting
- Stiff neck and painful neck movements
- Sensitivity to light
- Loss of consciousness progressing to comatose condition
- Seizures
How are Brain Aneurysm diagnosed?
- Cerebral Digital Subtraction Angiography (DSA)
- CT scan
- MRI scan
- Lumbar puncture (spinal tap)
Aneurysm, Cerbro-vascular
Carotid Artery Disease
Carotid artery disease occurs when arteries become narrower due to obstruction and cause reduced delivery of oxygen-rich blood to the brain and head. Carotid artery disease can lead to a stroke, a medical emergency in which blood supply to the brain is reduced and brain cells begin to die. A stroke can cause permanent disability or death.
Treatments for Carotid Artery Disease
If your blockage is severe or if you have already had a TIA or stroke, your doctor may recommend removing the blockage with one of the following surgical procedures
Carotid endarterectomy – In this procedure, plaque is removed from the carotid artery through an incision in your neck. The artery is repaired with either stitches or a graft. This is done under vision and many times complete blockage can be removed.
Carotid angioplasty and stenting –similar to cardiac angioplasty, a balloon is passed to the affected artery and stenosis is expanded and stent is placed to prevent future narrowing.
Symptoms of Carotid Artery Disease
- Numbness or weakness in your face or limbs, often only on one side of the body
- Inability to move one or more arm/ leg
- Difficulty in speaking and understanding
- Transient loss of vision
- Dizziness or loss of balance
- Severe headache with no known cause
How are Carotid Artery Disease diagnosed?
- Carotid ultrasound/ color doppler to assess blood flow and pressure in the arteries
- CT angio or MRI angio scan to look for evidence of a stroke or other abnormalities in arteries
- Angiography to produce better images of blood flow in the arteries
Aneurysm, Cerbro-vascular
Cavernous Malformation
A cavernous malformation is a cluster of dilated blood vessels (capillaries) with an enlarged and irregular structure. The walls of these capillaries are thinner than normal, have loose junctions between cells, and are prone to leaking.
Cavernous malformations can occur anywhere in the body, but they produce symptoms when they form in the brain or spinal cord. They can cause sudden deterioration when they bleed into the brain.
Treatments for Cavernous Malformation
If you are diagnosed but not experiencing symptoms, your doctor may recommend regular follow ups and MRI scans.
Medications, such as anti-epileptic drugs, may be prescribed to control your seizures or other symptoms.
If your symptoms are not responding to medication or there is repeated bleeding in the brain, surgical removal may be recommended.
Symptoms of Cavernous Malformation
- Seizures
- Headaches
- Bleeding in the brain (hemorrhage)
- Reduced vision
- Weakness, numbness, or paralysis of the limbs
- Memory difficulties
- Speech disturbances
- Unsteadiness of gait
How are Cavernous Malformation diagnosed?
- CT scan
- Angiography
- Electroencephalogram
- Blood tests
- Genetic testing
Aneurysm, Cerbro-vascular
Dural Arteriovenous Fistula
A dural arteriovenous fistula (DAVF) is a vascular abnormality formed by an abnormal connection between an artery and a vein within the tough covering of the brain (dura mater)
A DAVF can transfer high-pressure arterial blood into veins or venous sinuses that normally carry low-pressure, deoxygenated blood returning to the heart from the brain. This can cause neurological symptoms and bleeding into the brain (brain hemorrhage).
Treatments for Dural Arteriovenous Fistula
Many DAVFs can be treated without open surgery. endovascular embolization, a minimally invasive procedure in which a catheter is placed through the common femoral artery in the groin and passed through the arterial system until it reaches the DAVF.
The fistula is then blocked with a material such as glue, a metal coil, or a balloon to stop the abnormal pattern of blood flow.
For some DAVFs, microsurgery may be recommended in addition to endovascular embolization. Here Neurosurgery and Interventional Radiologist will work together to give best results for your problem
Symptoms of Dural Arteriovenous Fistula
- Bruit (abnormal sound associated with turbulent blood flow)
- Tinnitus (ringing in the ears)
- Headache
- Visual impairment
- Papilledema causing visual disturbances
- Seizures
- Hemorrhage in the brain producing deficits
How are Dural Arteriovenous Fistula diagnosed?
- MRI scan
- CT scan
- Digital subtraction Angiography of brain
Aneurysm, Cerbro-vascular
Moya Moya
Moyamoya disease is a condition of progressive blockage of your internal carotid arteries. These vessels make up two of the four arteries that bring blood to your brain. When they become blocked, as in moyamoya disease, you could potentially suffer a stroke or cerebral hemorrhage.
Treatments for Moya Moya
In a direct bypass, surgical connections are made between branches of your external and internal carotid arteries.
In an indirect bypass, tissues such as arteries, muscle, tissue underneath your scalp, or dura are placed on the surface of your brain. The area of your brain suffering from insufficient blood flow naturally causes blood vessels to reconnect between the transplanted tissues and ischemic arteries on the surface of your brain. This process restores blood flow to the affected area.
Symptoms of Moya Moya
- Stroke
- Cerebral Hemorrhage
How are Moya Moya diagnosed?
- MRI scan
- CT scan
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