Conditions & Treatments
The Emory MBNA Stroke Center uses a collaborative approach to stroke therapy to ensure that treatments are uniformly and appropriately provided for our patients. Treatments include drug therapy, surgery and interventional neuroradiology procedures. Below is an overview of each.
There are a wide variety of drugs that can be used to treat strokes. The patient's age and general physical condition must be considered, in addition to the severity and type of stroke that has occurred. Two basic drug therapies that are used for stroke include:
- Thrombolytic agents, which are drugs designed to dissolve the blood clot that is blocking a cerebral vessel, as with an Ischemic Stroke.
- Neuro-protective agents, which are drugs that attempt to minimize brain damage by protecting brain neurons that can continue to be destroyed for several hours following a stroke.
All forms of surgery for intracranial aneurysms are practiced, including care of the most complex basilar and giant aneurysms. In many instances, care of patients with both aneurysms and vascular malformations is augmented by techniques of interventional neuroradiology that provide less invasive methods for treating selected conditions affecting the blood vessels of the brain and spinal cord. Some surgical methodologies include:
A complete array of vascular surgical procedures for stroke including:
- Carotid Endarterectomy, which involves the removal of plaque from the carotid artery that leads to blood flow in the brain.
- Surgery for Aneurysm, which involves placing a metal clip across the neck of the aneurysm to cure the aneurysm, prevent future bleeding and maintain blood flow through the normal arteries.
- Surgery for Arteriovenous Malformation, which involves the surgical removal of a cluster of abnormal vessels that could rupture.
- Brain Bypass Surgery: Selected patients may benefit from microsurgical bypass operation designed to increase blood flow to areas of the brain with inefficient blood flow.
The development of the operating microscope and microsurgical techniques revolutionized such fields as neurosurgery. The magnification and illumination provided by these techniques allow experienced neurosurgeons to perform the most delicate operations with less risk and better outcomes for the patient.
Interventional neuroradiology is an important, less invasive treatment of neurovascular disorders from inside the blood vessels. Using very small catheters, called microcatheters, inserted into the vessels through a tiny puncture in the groin, interventional neuroradiologists can reach almost any vessel in the brain or spinal cord in a minimally invasive fashion. These endovascular approaches can be used to open narrowed or blocked arteries, dissolve clots in brain arteries, repair certain aneurysms and close abnormal blood vessels that are at risk of bleeding. These methods often avoid the need for more invasive surgery.
The Emory MBNA Stroke Center includes three of the region's most experienced interventional neuroradiologists who are experts in these procedures and have been at the forefront of innovations in interventional techniques including:
- Endovascular Thrombolysis: This treatment allows neurosurgeons to treat blocked arteries by threading microcatheters from an artery in the groin to a blocked artery in the brain. Clot-busting drugs are injected into the artery to dissolve the clot and restore blood flow to the brain faster than many other medications.
- Cerebral Angioplasty and Stenting: This procedure uses balloons and/or stents, which are inserted via a catheter to open up the narrowed or blocked vessels in the brain.
- Aneurysm Coiling: Certain brain aneurysms can be treated by inserting a microcatheter into the aneurysm and filling it with coils made of soft platinum metal.
- Embolization: : During embolization, a catheter is threaded through the blood vessels until it reaches an abnormal tangle of blood vessels (such as a vascular malformation-AVM). One of a variety of materials can be injected through the microcatheter into the abnormal vessels to prevent future bleeding or to assist in the overall treatment of the malformation by other means such as surgery or radiosurgery.
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