Interventional Neurology

The specialty of neurology encompasses a wide range of disorders that affect the body's nervous system, which includes diseases of the brain, spinal cord, nerves, and muscles. Interventional Neurology is a subspecialty within Neurology. It uses catheters and radiology to diagnose and treat various conditions and diseases of the central nervous system using minimally invasive neurosurgical techniques.

The central nervous system is made up of the brain and the spinal cord. Interventional Neurology uses tools that pass through the blood vessels to diagnose and treat diseases and conditions rather than using open surgery. These physicians use advanced radiology imaging and 3D technology to help them see and treat the part of the body for diagnosis and treatment.

Conditions where it can be used:

1. Brain and Spinal Vascular Malformations

2. Cerebral Aneurysm – Bulging, weakening of an artery supplying blood to the brain

3. Extracranial & Intracranial Atherosclerosis – Hardening of arteries that supply blood to the head and neck

4. Head and Neck Tumors

5. Neck Lesions

6. Severe Nosebleeds

7. Stroke/Blood Clot in the Brain

8. Subarachnoid Hemorrhage (SAH) – Bleeding/bursting of a blood vessel in the brain

Techniques used:

• Angiography – Procedure that looks at how blood is flowing in the neck and brain vessels to determine whether the vessels are diseased, narrowed, enlarged or blocked

• Coil Embolization – Insertion of a very thin wire (coil) to block blood flow to an area

• Embolectomy – Removal of a blood clot that caused the stroke

• Stenting – Insertion of a balloon and/or tiny metal tube (stent) to open a narrowed vessel/artery

• Thrombectomy - threading a catheter through an artery in the patient’s groin to the blocked artery in the brain. A device at the end of the catheter attaches to the clot; the neurologist removes the trapped clot and blood flow to the brain resumes within minutes. Brain cells are no longer deprived of oxygen.

Future Trends:

The field of endovascular neurosurgery has resulted in effective endovascular therapies for carotid-cavernous fistulas(CCFs), intracranial aneurysms, arteriovenous malformations (AVMs), dural arteriovenous fistulas, atherosclerosis of cerebral arteries, acute stroke, carotid artery disease, and vascular tumors of the head, neck, and spinal vascular malformations and tumors. The scope of practice of neurovascular endovascular surgery has become complex, requiring training in specific skill sets and techniques. The evolution of the neuroendovascular field has resulted in the development of program requirements for residency or fellowship education in endovascular neurosurgery.