Conditions

Stroke is a leading cause of death and the leading cause of disability in the United States. When a stroke occurs, a blood vessel in the brain becomes blocked or ruptures —this can cause permanent brain injury or even death. However, rapid treatment and expert follow-up care may protect brain cells and help patients resume their lives. 

Learn more about the differenty types of strokes. 

Arteriovenous Malformations

  • Arteriovenous malformation (AVM) is an abnormal connection between arteries and veins of the brain
  • Usually present from birth and may cause headache, seizure or bleeding into the brain (hemorrhage)
  • Treatment include surgery, radiosurgery or embolization

Arteriovenous Malformations (AVMs) are a relatively infrequent condition in which there is an abnormal connection between arteries that normally supply brain tissue and veins. This usually appears as an abnormal tangle of blood vessels and causes abnormal high flow through the lesion. AVM's can occur either in the brain or the spine and are generally present from birth. Brain AVMs may cause symptoms of headache, seizure, or rupture while spinal AVM's can cause weakness, paralysis, or loss of bowel and bladder function. Rupture of an AVM is the most serious problem and results in bleeding in the brain (intracranial hemorrhage) or spinal cord. Overall there is approximately a 2-4% annual risk of rupture for patients with previously unruptured brain AVMs.

AVMs are most commonly treated either by brain surgery or radiosurgery. Radiosurgery is a method that uses directed radiation on the abnormal vessels to cause them to shrink. This method is most effective for smaller AVMs. Embolization is a method of treating AVMs by placing tiny catheters upstream of the AVM and injecting materials under x-ray guidance to block the abnormal vessels. These materials can include coils or liquid adhesives and can cause significant reduction of the AVM size. Embolization prior to surgery can decrease blood loss and time required for surgical removal of the AVM. Embolization prior to radiosurgery can increase the likelihood that the AVM will resolve following radiation therapy.

Hemorrhagic Stroke

A hemorrhagic stroke is the accumulation of blood anywhere within the skull vault.

Intracranial hemorrhage is a serious medical emergency because the buildup of blood within the skull can lead to increases in intracranial pressure, which can crush delicate brain tissue or limit its blood supply. Severe increases in intracranial pressure can cause potentially deadly brain herniation, in which parts of the brain are squeezed past structures in the skull.

Diagnosing Hemorrhagic Stroke

CT scan (computed tomography) is the definitive tool for accurate diagnosis of an intracranial hemorrhage.

For patient assistance, the treatment team at Emory uses multidisciplinary physician teams, state-of-the-art technology and the highest quality patient care.

Intracranial Aneurysm

An aneurysm represents a weak spot in the wall of an artery which results in a "focal bulge" or widening of the artery. In the brain, these aneurysms have a 2-4% annual risk of rupture which can result in "subarachnoid hemorrhage", or bleeding in the space around the brain.

There are approximately between 12,000 and 28,000 subarachnoid hemorrhages annually in the United States. Patients with subarachnoid hemorrhages will usually complain of "the worst headache of his/her life" and can have nausea, vomiting, visual changes, neck stiffness, and loss of consciousness. A hemorrahage of this type is considered a medical emergency: 10-15% of these patients dying prior to reaching the hospital. Of those who do reach the hospital, half usually do not survive beyond 30 days, with the majority of the other half of survivors suffering a permanent stroke.

Currently, there are two methods of treating intracranial aneurysms:

  • Brain surgery with placement of a clip around the neck of the aneurysm.
  • Embolization of the aneurysm with placement of platinum GDC coils from inside the blood vessel through a catheter in the groin.

At Emory is a national leader, specializing in the treatment of aneurysms using the GDC (Guglielmi Detachable) Coils.

Learn more about GDC therapy of intracranial aneurysms.

Ischemic Stroke

In an ischemic stroke, blood supply to part of the brain is decreased, leading to dysfunction of the brain tissue in that area.

An ischemic stroke (cerebral infarction) occurs when a blood vessel that supplies a part of the brain becomes blocked. This loss of blood supply results in the death of brain tissue in that area. Cerebral infarctions vary in their severity with one third of the cases resulting in death.

Diagnosing Ischemic Stroke

Stroke remains a diagnosis based upon clinical exam findings. By understanding deficits that result from brain lesions, a neurologist is capable of localizing a stroke to a specific lobe or hemisphere of the brain. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) scanning are capable of showing damaged area in the brain and rule out other causes of neurologic deficits, i.e. hemorrhage, tumor, subdural hematoma or other brain disorder. Vessel imaging to identify the arterial blockage can be performed with CT Angiography (CTA), MR Angiography (MRA) or conventional angiography by neurointerventionalists.

For patient assistance, the treatment team at Emory uses multidisciplinary physician teams, state-of-the-art technology and the highest quality patient care.

To schedule an appointment or learn more about stroke, please call 404-778-5770.

How Can We Help You Today?

Need help? We will be delighted to assist you today, so please call us at 404-778-7777. We look forward to hearing from you.