Vascular neurosurgery

Vascular neurosurgery is a complex and highly specialized area of neurosurgery. The division offers a joint multidisciplinary consultation between neurosurgery and neuroradiology. Its purpose is to answer all questions concerning non-drug treatment of diseases and malformations of the cerebral vessels and their follow-up.

The treatments are discussed at the multidisciplinary symposium in close collaboration with the interventional neuroradiology team that carries out endovascular treatments. In some cases, combined treatments are offered, always with the goal of maximizing patient safety.

Vascular neurosurgery treats diseases of the blood vessels in and around the brain such as aneurysms, arteriovenous deformities (AVDs), dural fistulas or cavernomas.

• Aneurysms, which are usually asymptomatic, are localized dilations of the artery wall leading to the formation of a pocket of blood. If the aneurysm ruptures, patients have very severe headaches, sometimes accompanied by neurological disorders. In case of rupture, emergency treatment must be carried out, either through endovascular treatment (catheter) or through surgery, depending in particular on the location and size of the aneurysm.
   
• Arteriovenous deformities (AVD) are abnormal connections between veins and arteries. Because of the difference in blood pressure between these two types of vessels, a nidus is formed, which is a sort of intertwining of the vessels like a ball of wool. AVDs may cause bleeding or epileptic seizures. Depending on the case, they are treated by radiosurgery, through endovascular (catheter) treatment or surgery (resection of the lesion).
   
• Dural fistulas are also abnormal connections between arteries and veins. In this case, veins are found in the dura (envelope of the brain) and are called venous sinuses. They may cause bleeding or epileptic seizures. Depending on the case, they are treated through endovascular (catheter) treatment or surgery (resection of the lesion).
   
• Cavernomas, which are usually asymptomatic, are deformities of veins. These lesions may cause bleeding or epileptic seizures. Surgical treatment may be considered in case of symptoms.

The division has a specific operating room that enables very detailed visualization of vessels. For patients, this is an additional guarantee of safety. In addition, the equipment in this room provides the possibility to combine several treatments.

Interventional neurosurgeons and neuroradiologists work with a specially trained team. Together, they ensure maximum safety conditions during the operation through continuous monitoring of neurological functions (neuromonitoring). Then a specialized team from the intensive care division monitors patients during the first night after the intervention. After this, patients are treated in the care unit of the Neurosurgery Division before they can go home.