Vascular neurosurgery is a complex subspecialty that treats injuries related to hemorrhage or infarction in the brain or spinal cord.
Vascular neurosurgery is the part of neurosurgery that treats those injuries that have caused or may cause hemorrhages or infarcts in the brain or spinal cord.
It is a very complex subspecialty, due to the high technical requirements it requires, its relatively infrequent occurrence and the consequences that these lesions can have on the patient’s life and function.
In general, it deals with arterial aneurysms, vascular malformations and dural arteriovenous fistulas. He also treats cavernomas, which are halfway between vascular and tumor lesions, and some diseases that can cause cerebral infarctions, such as Moya-Moya disease.
Briefly summarizing its field of action, we will see each of these lesions:
– Regarding cerebral aneurysms: they are arterial dilatations secondary to the weakening of the vessel wall that appear in the bifurcations of the cerebral arteries. They can be diagnosed by chance in the course of a study for another cause or be symptomatic. When they are symptomatic they should be treated, either by microsurgery or endovascular treatment. The aim is to exclude the aneurysm completely from circulation. Regarding asymptomatic aneurysms, it is assumed that they should be treated, due to the risk of rupture, those that have shown growth or are irregular. It is essential to be evaluated by a neurosurgeon with extensive experience.
– Regarding arteriovenous malformations, most are diagnosed after bleeding. In these cases it is essential that the patient goes to a center or neurosurgeon with a lot of experience, since the surgery of brain and spinal malformations is possibly the most complicated among the operations performed in neurosurgery. Depending on the malformation, its location and size, and the patient’s age, the best treatment should be chosen.
– In relation to dural arteriovenous fistulas, depending on the location (cranial/spinal), surgical or endovascular treatment can be performed. Spinal arteriovenous fistulas are usually better solved by surgery.
– In reference to cavernomas, if they have to be treated, the treatment of choice is surgical, although in each case the need for treatment must be individualized.