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Cerebrovascular Diseases and Disorders
Diseases and disorders affecting the brain blood vessels - such as strokes, aneurysms and arteriovenous malformations - are treated through a collaborative approach that includes neurologists, neurosurgeons, cranial base surgeons, neuroradiologists, neuroanesthesiologists and others. Some of these problems can be treated surgically. Technologies that are key to success in treatment include the intraoperative angiography, which enables surgeons to visualize the blood vessels during surgery.
Cerebrovascular disease refers to any disease of the blood vessels and, in particular, the arteries that supply blood to the brain. Stroke occurs when a blood vessel in the brain is blocked or bursts. Transient ischemic attack (TIA, "mini-stroke") occurs when blood flow to part of the brain is blocked or reduced, often by a blood clot. After a short time, blood flows again and the symptoms go away.
Cerebrovascular disease may be associated with different risk factors, including high blood pressure, high cholesterol, diabetes or tobacco use. Rapid diagnosis is critical for the best possible recovery. Medicines may be used initially, and then treatments may shift to rehabilitation and prevention of other problems and future strokes.
Through a unique, joint venture between the neurology, neurosurgery, cardiovascular and radiology programs, cerebrovascular disorders such as aneurysms, tumors (including glomus tumors), carotid stenosis and stroke can be treated without surgery by approaching the problem endovascularly – from within the blood vessels. For example, Loyola is one of the few centers nationwide performing the GDC procedure (Guglielmi Detachable Coil) in which a soft platinum alloy microcoil is placed through the femoral artery into a cerebral aneurysm, isolating it from circulation and thereby reducing pressure and the likelihood of rupture and stroke.
Carotid Artery Stenting/Angioplasty
The carotid arteries are the main blood vessels supplying blood flow to the brain. Before stent placement, a guide wire with a filter is positioned past the narrowed area in the carotid artery and a small balloon is inflated to widen the artery. Then a stent is placed to provide support. The filter captures particles that may have been released during the procedure to prevent a stroke. Within weeks, the artery grows over the surface of the stent. With angioplasty, a catheter is used to compress plaque in the carotid artery, creating a bigger opening to permit more blood flow into the brain.
Intraoperative angiography is an important, low-risk imaging technique used in the treatment of patients with aneurysms, arteriovenous malformations (AVMs) and arteriovenous dural fistulae (AVDF). Loyola neurosurgeons routinely utilize this precise diagnostic tool to visualize the blood vessels at microscopic levels during surgery to help ensure normal vascular flow before the procedure has been completed.
Our neurosurgeons' effective use of this technique has resulted in improved patient surgical outcomes and the reduction of postoperative angiography and repeat surgery as well as the reduction of the patient’s risk of stroke.
Interventional Neurovascular Applications Laboratory
A new interventional neurovascular applications laboratory enables scientists to teach interventional techniques and test innovative treatments for cerebrovascular diseases. Some of the principal avenues of research include testing ways to seal off aneurysms with polymer compounds or metal coils, using special glue to treat arteriovenous malformations and using new technologies (such as balloon occlusion testing) to measure cerebral blood flow. A new state-of-the-art cerebral blood flow laboratory enhances the management of both interventional and open surgical cerebrovascular cases.