Neurosurgery is a type of surgery that treats disorders of the brain, spine, spinal cord, and peripheral nerves. Neurovascular surgery, a subspeciality of neurosurgery, involves comprehensive management of blood vessel and associated conditions and disorders of the brain and spinal cord. this includes. both surgical and endovascular treatment of patients with stroke, aneurysms, vascular malformation and carotid disease as well as management of complex vascular tumours. the word endovascular means “inside a blood vessel.” endovascular neurosurgery is also known as neuro-interventional surgery.

It is performed with the use of catheters and other small devices. Endovascular intervention is an alternative treatment to standard open surgery, which is more invasive. “The benefit of such therapy is that the lesion is treated less invasively, which frequently results in quicker recovery times and more successful treatment,” says DR G Horton a leading Endovascular Neurosurgeon at Arwyp Medical Centre. He treats cerebral aneurysms, stroke, carotid disease, arteriovenous malformations using minimally invasive neuroendovascular procedures as well as surgery involving microsurgical techniques.

Neuroendovascular Procedures

The following neuroendovascular procedures are performed at Arwyp Medical Centre:

-Thrombolytic therapy (intravenous and intra-arterial). This uses medicine to dissolve a clot in a blood vessel in the brain.

-Endovascular mechanical thrombectomy This uses a small catheter to remove a blood clot that is blocking the blood flow in a brain artery.

-Endovascular coiling This is done to treat a brain aneurysm. A brain aneurysm is a bulge in a weak spot in the wall of an artery in the brain that fills with blood. the bulge is at risk of a tear(rupture). this would cause bleeding on the brain. to prevent this, a surgeon puts a very thin metal coil inside the aneurysm. it blocks blood flow into the bulging area. it may also be closed with a clip.

-Cerebral angiography (DSA) This is a diagnostic radiological procedure. it demonstrates the circulation of blood in the brain.

-Carotid artery angioplasty and stenting (CAS) The carotid arteries send blood and oxygen to the brain. this procedure uses a small ballon to open a carotid artery that has become too narrow. A tiny mesh stent is then put in place to keep the artery open.

Surgical Management

Surgical management of neurovascular disorders involves brain and spinal surgery to directly address the patient’s condition. the following surgical neurovascular procedures are performed at Arwyp Medical Centre:

-Intracranial Aneurysm Microsurgical clip ligation A titanium clip(s) is placed at the base of the brain aneurysm to permanently exclude the aneurysm from the normal circulation and prevent future bleeding from the aneurysm. the surgery is performed using a high-powered microscope and microsurgical techniques.

-Microsurgical Resection of brain and spinal cord arteriovenous malformation (AVM) a blood vessel malformation in the brain or spinal cord is removed surgically using high powered microscope visualization and microsurgical techniques.

-Microsurgical ligation of brain and spinal Dural arteriovenous fistulas (DAVF) Abnormal connections of blood vessels in the brain or spine are surgically eliminated using high powered microscope visualization and microsurgical techniques.

-Carotid endarterectomy (CEA) an incision is made in the carotid artery to remove plaques and restore normal circulation to the brain. When possible, this surgery is performed without the need for general anaesthetic is given, allowing safer surgery as well as eliminating the risk of general anaesthesia. “Awake” CEA also allows for shorter hospital stay and recovery time after surgery.

-Microsurgical resection of brain and spinal cord cavernous malformation blood vessel-type lesions located within the brain or spinal cord are surgically removed using high powered microscope visualization and microsurgical techniques.