Dr. Dhanish Parekh

Neurovascular Surgery

Neurovascular surgery focuses on the diagnosis and treatment of conditions affecting the blood vessels of the brain and spinal cord. This specialized field addresses various disorders, including aneurysms, arteriovenous malformations (AVMs), carotid artery disease, and more.

Key Conditions Treated

Cerebral Aneurysms

Weakness in a blood vessel wall that can bulge and potentially rupture, leading to hemorrhagic stroke.

Arteriovenous Malformations (AVMs)

Abnormal connections between arteries and veins, which can cause bleeding or neurological symptoms.

Carotid Artery Disease

Narrowing of the carotid arteries, which supply blood to the brain, increasing the risk of stroke.

Intracranial Atherosclerosis

Hardening and narrowing of the arteries within the brain, leading to reduced blood flow and risk of stroke.

Ischemic Stroke

Often due to blockage of blood flow, which may be treated through various surgical interventions.

Surgical Techniques

Endovascular Surgery

Minimally invasive procedures performed through blood vessels, using catheters and imaging guidance.

Techniques include:

• Coiling: Placing coils in an aneurysm to promote clotting and seal it off from circulation.
• Stenting: Inserting a stent to support blood vessels or to maintain blood flow through narrowed arteries.

Open Surgery

Traditional surgical techniques involving larger incisions.

Procedures include:

• Clipping: Directly placing a clip across the neck of an aneurysm to prevent blood flow.
• Resection: Removing an AVM directly from the brain.

Carotid Endarterectomy

A procedure to remove plaque from the carotid artery to restore proper blood flow and reduce stroke risk.

Bypass Surgery

Creating an alternative route for blood flow around blocked arteries, typically used in severe cases of cerebral artery disease.

Risks and Considerations

• Complications: As with any surgical procedure, risks include infection, bleeding, stroke, and neurological deficits.
• Patient Selection: Careful evaluation is necessary to determine the best treatment approach based on individual anatomy and medical history.

Recovery

• Postoperative Care: Recovery depends on the type of procedure performed. Monitoring for complications is crucial, and rehabilitation may be needed for recovery of neurological function.
• Follow-Up: Regular follow-up appointments are essential to monitor healing and manage any ongoing risks.

Summary

Neurovascular surgery plays a critical role in treating conditions affecting the brain and spinal cord's blood vessels. By employing both minimally invasive and open surgical techniques, neurosurgeons aim to prevent serious complications like stroke and improve patient outcomes. A multidisciplinary approach, often involving neurologists and interventional radiologists, ensures comprehensive care for patients with neurovascular disorders.