Neuroendovascular Surgery (NES)

An acute stroke occurs when the brain experiences a sudden interruption of blood flow. There are two types of acute stroke: ischemic and hemorrhagic. In an ischemic stroke, a blood vessel is blocked by a clot that either develops in the fatty plaque of a blood vessel in the brain (cerebral thrombosis) or in another part of the body before traveling to the brain (cerebral embolism). In a hemorrhagic stroke, an artery in the brain begins to bleed, usually due to an arteriovenous malformation (AVM) or brain aneurysm. A stroke is a very serious medical emergency. Stroke symptoms can strike suddenly or may fluctuate in severity over a few hours, and may include numbness, confusion, vision changes, trouble walking and severe headache.

Remember the B. E. F.A.S.T. warning signs to recognize a stroke:

• Balance or dizziness
• Eyes or blurred vision
• Face drooping
• Arm weakness
• Speech difficulty
• Time to call 911

We offer a minimally invasive biplane endo/angio suite, which extends the window of time to treat stroke patients by up to 12 hours (traditional treatment options call for a three-to-four-hour window after the onset of stroke symptoms). By utilizing 3D imaging, the interventional neuroradiologist can determine exactly where the catheter-based clot retrieval device needs to be and can ensure that no other blood clots are overlooked. 

Most patients are treated with traditional and alternative options including intravenous tPA, a medication administered through an IV that dissolves blood clots and is most effective when given within three hours of the start of stroke symptoms).

A brain tumor develops when abnormal cells multiply and form a mass or growth in or near your brain. There are several types of brain tumors, including benign (noncancerous) and cancerous tumors. Primary brain tumors begin in the brain, while secondary/metastatic tumors begin in other parts of the body and spread to the brain. Symptoms of a brain tumor can vary depending on the type and location, but may include:

• Severe and/or frequent headaches.
• Unexplained nausea or vomiting.
• Vision changes including blurred or double vision, or loss of peripheral vision.
• Changes in sensation or movement in an arm or leg.
• Difficulty with balance.
• Unexplained confusion or personality/behavior changes.
• Seizures, especially without a prior history.
• Hearing problems.

Diagnosing a brain tumor may involve several tests and procedures, including a neurological exam, imaging tests, a CT scan to determine the presence of other cancer in the body, and a biopsy of abnormal tissue during surgery or with a needle. Treatment of a brain tumor will depend on the size, type and location of the tumor. Treatment options may include surgery, radiation therapy, radiosurgery, chemotherapy and targeted drug therapy.

An arteriovenous malformation (AVM) is a rare congenital defect in which the connection between arteries and veins is disrupted, most commonly in the brain or spine. AVMs are often present at birth and may not cause symptoms for many years, even into adulthood. When symptoms do appear, they may include sudden/severe headache or back pain, weakness in the arms or legs, stiff neck, and vomiting. An AVM rupture is a medical emergency, as it may lead to a stroke or brain aneurysm.

Treatment will aim to prevent hemorrhage and reduce symptoms like seizures, and treatment options will depend on the size and location of your AVM, as well as your age and general health. Certain medications may effectively reduce symptoms, but surgery is the most common course of treatment. Surgical options include removal of the AVM if possible via traditional brain surgery or endovascular embolization via a catheter to reduce blood flow to the affected area of the brain. A procedure called stereotactic radiosurgery uses highly-targeted radiation beams to precisely target and destroy smaller AVMs or those that would be difficult to remove surgically.

A brain aneurysm is an abnormally bulging artery in the brain caused by a weak spot in the blood vessel wall. As the aneurysm grows in size, it can cause symptoms like severe headaches and unexplained nausea. If an aneurysm is undetected and untreated, it can rupture and cause severe disability, cognitive loss and death.

It is important to detect and diagnose aneurysms as early as possible to prevent sudden death or serious complications. We provide several traditional and innovative techniques for aneurysm treatment, including surgical clipping, endovascular coiling and endovascular embolization. Our interventional neuroradiologists are the only providers in Brevard and Indian River counties to offer minimally invasive endovascular surgery for brain aneurysm repair, and we are available 24/7 to treat aneurysm rupture.