Neurovascular Surgery 2017-05-16T12:17:07+00:00

Neurovascular Surgery

The Neurovascular Section at UIC integrates both cerebrovascular surgery and neuroendovascular procedures in a multi-modality approach to treatment of cerebrovascular disease. The service manages the full range of neurovascular diseases including aneurysms, arterio-venous malformations, cavernous malformations, carotid stenosis, and intracranial occlusive disease requiring endovascular stenting or extracranial-intracranial bypass.

Illinois Brain Aneurysm Center

The Illinois Brain Aneurysm Center offers the most comprehensive care from a highly experienced team dedicated to developing and implementing the best methods for treating this disease. Our physicians are recognized for their innovations and excellence in helping thousands of patients with brain aneurysms.

Neurosurgeons at the University of Illinois Hospital & Health Sciences System have treated more than 1,000 aneurysms in the last four years. That’s more than anyone else in Illinois.

  6 minute informational video about aneurysms.

What is a BRAIN ANEURYSM?

A brain aneurysm is a weak or thin spot on a blood vessel in the brain that balloons out and fills with blood. The bulging aneurysm can put pressure on a nerve or surrounding brain tissue. It may also leak or rupture, spilling blood into the surrounding tissue (also called a hemorrhage).

Some cerebral aneurysms, particularly those that are very small, do not bleed or cause other problems. Cerebral aneurysms can occur anywhere in the brain, but most are located towards the front and form on blood vessels where they branch as they enter the brain..

It is unknown what causes a brain aneurysm, however, research in the field suggests there are both genetic and environmental factors that contribute to their appearance and possible growth and possible rupture.

Aneurysms usually do not cause symptoms unless they are growing or rupture and bleed. They can be found incidentally on imaging of the brain through CT scan and MRI. If an aneurysm ruptures, it causes bleeding into a layer of the brain called the subarachnoid space and can result in death or severe disability and is thus considered a medical emergency. Patients often present with a “thunderclap headache” of sudden onset, described as the worst headache of their life.

One of the challenges facing neurosurgeons is to determine who is at risk for aneurysm rupture and may benefit from treatment. According to the Brain Aneurysm Foundation, around 1 in 50 people in the United States have an unruptured brain aneurysm, and the annual rate of rupture is approximately 8-10 per 100,000 people. Most aneurysms are seen between the ages of 35-60 and are more prevalent in women at a ratio of 3:2.

 saccular aneurysm

This illustration depicts a saccular aneurysm at the branching of two vessels. The arrows denote the direction of blood flow.

 

What is MOYAMOYA?

Moyamoya disease is a rare, progressive cerebrovascular disorder caused by blocked arteries at the base of the brain in an area called the basal ganglia. The name “moyamoya” means “puff of smoke” in Japanese and describes the look of the tangle of tiny vessels formed to compensate for the blockage.  Moyamoya disease was first described in Japan   in the 1960’s and it has since been found in individuals in the  United States, Europe,  Australia, and Africa.  The disease primarily affects children, but it can also occur in adults.   In children, the first symptom of Moyamoya disease is often stroke, or recurrent transient ischemic attacks (TIA, commonly referred to as “mini-strokes”), frequently accompanied by muscular weakness or paralysis affecting one side of the body, or seizures.  Adults most often experience a hemorrhagic stroke due to recurring blood clots in the affected brain vessels.   Individuals with this disorder may have disturbed consciousness, speech deficits (usually aphasia), sensory and cognitive impairments, involuntary movements, and vision problems.  Because it tends to run in families, researchers think that Moyamoya disease is the result of inherited genetic abnormalities.  Studies that look for the abnormal gene(s) may help reveal the biomechanisms that cause the disorder.

(Taken from the National Institute of Neurological Disorders and Stroke)

MoyaMoya

This is an angiogram demonstrating a classic example of moyamoya. Note how it resembles smoke, hence its name.

What is an AVM?

Arteriovenous malformations (AVMs) are defects of the circulatory system that are generally believed to arise during embryonic or fetal development or soon after birth.  Although AVMs can develop in many different sites, those located in the brain or spinal cord can have especially widespread effects on the body.  Most people with neurological AVMs experience few, if any, significant symptoms.  The malformations tend to be discovered only incidentally, usually either at autopsy or during treatment for an unrelated disorder. But for about 12 percent of the affected population (about 36,000 of the estimated 300,000 Americans with AVMs), these abnormalities cause symptoms that vary greatly in severity.  Seizures and headaches are the most generalized symptoms.  AVMs also can cause a wide range of more specific neurological symptoms that vary from person to person, depending primarily upon the location of the AVM.  Such symptoms may include muscle weakness or paralysis, loss of coordination, difficulties carrying out tasks that require planning, dizziness, visual disturbances, problems using or understanding
language, abnormal sensations (such as numbness, tingling, or spontaneous pain), memory deficits,  mental confusion, hallucinations, or dementia.

(From the National Institute of Neurological Disorders and Stroke)

AVM

This illustration depicts an Arteriovenous Malformation (AVM). Both arteries and veins contribute to this tangle of vessels.

What is CAROTID DISEASE?

Carotid artery disease is a condition in which a fatty material called plaque builds up inside the carotid arteries. You have two common carotid arteries—one on each side of your neck—that divide into internal and external carotid arteries.  The internal carotid arteries supply oxygen-rich blood to your brain. The external carotid arteries supply oxygen-rich blood to your face, scalp, and neck. Carotid artery disease can be very serious because it can cause a stroke, or “brain attack.” A stroke occurs when blood flow to your brain is cut off.  If blood flow is cut off for more than a few minutes, the cells in your brain start to die. This impairs the parts of the body that the brain cells control. A stroke can cause lasting brain damage, long-term disability, paralysis (an inability to move), or death.

(From the National Institute of Health)

Common Carotid Artery


This illustration depicts the Common Carotid Artery and its branches, the External Carotid Artery and Internal Carotid Artery.
The inset demonstrates a cut-away view of the branching. The arrows denote the direction of blood flow. Plaque buildup is the yellowish mass that can reduce blood entering the Internal Carotid Artery, or be a source of emboli (small particles) which can travel to the brain and cause stroke.

What is VERTEBROBASILAR DISEASE?

People with blockage of the main blood vessels to the back of the brain (the vertebral or basilar artery) are at risk of  having strokes, which can be due to reduced blood flow to the brain. In some people with blockage, the brain can get plenty of blood through other natural blood vessel pathways. In other people, however, there may not be enough blood flow.  Currently, it is not  known if the amount of blood flow to the brain increases or decreases the chances of a stroke in the back of the brain in people with blockages of the vertebral or basilar artery.

Vertebrobasilar cerebrovasculature

This illustration depicts the Vertebrobasilar cerebrovasculature.