UT Southwestern Medical Center treats every
kind of vascular malformation of the brain, including the rarest types of these
blood vessel disorders.
Every neurosurgeon on our brain vascular malformations
team has specialized fellowship training in the management of cerebrovascular
disorders. Many of our physicians have dual training in both neurosurgery and
radiology.
Comprehensive Treatment Options
Every patient’s case is reviewed by all our
cerebrovascular specialists before any treatment begins. In some cases,
observation is the best strategy. In other cases, interventional treatment is
warranted to minimize the risk of bleeding or stroke from a vascular
malformation.
Interventional treatment options might
include one or more of these techniques:
Open Surgery
Open surgery is the longest-established
treatment for vascular malformations of the brain. In open surgery, one of our neurosurgeons
performs a craniotomy, in which a portion of the skull is removed to allow
access to the vascular malformation. The specific technique depends on the type
of malformation, but the goal is complete removal of the malformation in an
attempt to eliminate any future problems.
Endovascular Embolization (Neurointerventional Surgery)
This procedure involves injecting liquid glue
or tiny metal coils via a catheter to block the blood supply to the
malformation. This technique can help eliminate or shrink the malformation. A
neurointerventional radiologist inserts the catheter through the groin and
threads it up into the arteries in the brain leading to the vascular
malformation.
Hybrid Procedures
Our experienced neurosurgeons now have the
ability to combine endovascular and surgical procedures in the same operative
suite. This hybrid operating room allows pinpoint accuracy when locating the
vascular malformation and also allows the surgeon to confirm complete treatment
without transferring the patient to another area of the hospital. New
treatments designed for hybrid operating theaters allow more direct access to
areas where standard access is more dangerous.
Stereotactic Radiosurgery
This procedure involves directly targeting a
single treatment of high-energy radiation delivered by a linear accelerator (or
Gamma Knife or CyberKnife) to cause the abnormal vessels to close over time.
The precise targeting of radiosurgery minimizes damage to surrounding areas of the
brain. Performed by a team that includes a cerebrovascular neurosurgeon, a
radiation oncologist, and a radiation physicist, radiosurgery is a less common
form of treatment. Because UT Southwestern frequently uses stereotactic
radiosurgery to treat cancer patients, our experts are highly skilled at
performing the procedure.
Watchful Waiting
In some cases, immediate treatment might not
be necessary or recommended because the vascular malformation might not be in
danger of rupturing or bleeding, or there are no symptoms, or surgery might be
considered too dangerous. In those cases, our team will continue to observe the
vascular malformation, performing regular imaging tests and discussing any developing
changes with the patient.
