Cerebrovascular Disease

Cerebrovascular diseases encompass a variety of conditions that impact the blood vessels and blood flow in the brain. These conditions can lead to serious health issues such as strokes, aneurysms, and other vascular malformations. Early diagnosis and treatment are critical to preventing complications and improving patient outcomes.

Symptoms of cerebrovascular disease vary depending on the location of the blockage in the brain, including:

• Sudden, severe headache
• Dizziness, nausea, or vomiting
• Confusion, disorientation, or memory loss
• Numbness or weakness in the face, arm, or leg, particularly on one side
• Difficulty speaking or understanding speech
• Vision problems, such as blurred or double vision
• Loss of balance or coordination

In an emergency, always call 911. Immediate action is essential for survival and reducing long-term effects.

Diagnosis typically involves a combination of physical examinations and advanced imaging techniques, including:

• Electroencephalogram (EEG): Measures the brain’s electrical activity.
• Lumbar puncture (spinal tap): Collects cerebrospinal fluid to check for bleeding.
• Magnetic Resonance Imaging (MRI): Provides detailed images of brain structures.
• Magnetic Resonance Angiogram (MRA): Visualizes brain blood vessels to detect blockages or aneurysms.

Causes of Cerebrovascular Disease

Cerebrovascular disease can develop due to various factors, including:

• Atherosclerosis: Plaque buildup in arteries that can reduce or block blood flow to the brain.
• Blood clots: Can form in brain arteries or travel from other body parts, leading to ischemic stroke.
• Hypertension: Chronic high blood pressure can damage blood vessels, making them prone to narrowing, rupturing, or developing aneurysms.
• Aneurysms: Weak spots in blood vessel walls that can bulge and burst, causing hemorrhagic stroke.
• Vascular malformations: Abnormal connections between arteries and veins that disrupt normal blood flow and can lead to hemorrhage.
• Diabetes: High blood sugar levels can damage blood vessels over time.
• Obesity: Excess weight can contribute to high blood pressure, diabetes, and other conditions increasing cerebrovascular disease risk.
• Smoking: Tobacco use can damage blood vessels and increase the risk of blood clots.
• Sedentary lifestyle: Lack of physical activity can contribute to obesity, hypertension, and other risk factors.

Contributing Risk Factors for Cerebrovascular Disease

Several risk factors can increase the likelihood of developing cerebrovascular disease:

• Age: Risk increases with age.
• Family history: Genetic predisposition to cerebrovascular conditions.
• Lifestyle factors: Smoking, poor diet, lack of exercise.
• Medical conditions: Hypertension, diabetes, high cholesterol.

Treatment for Cerebrovascular Disease:

The Intent Medical Group offers comprehensive open vascular and endovascular neurosurgical care. We specialize in treating both adult and pediatric patients with brain aneurysms, brain arteriovenous and cavernous malformations, as well as carotid disease and those in need of bypass. The Intent Medical Group aneurysm practice is one of the busiest in the state of Illinois.

An aneurysm forms on a blood vessel in the brain. Blood vessels are like tubes where blood flows inside the brain. Sometimes pouches can form on the side of those tubes. These pouches are known as aneurysms. With time, they can grow, and just like a balloon that’s inflated too much, they can burst. When an aneurysm bursts, it’s a life-threatening condition because it releases a massive amount of blood into the brain.

An aneurysm that has bled is an emergency and must be treated. Aneurysms that have not bled can be treated in one of three ways:

Observation: We do not just treat the aneurysm but follow it with imaging every six to 12 months

Open Surgery:

• Aneurysm Clipping: This involves making an incision on the scalp behind the hairline. We then open a small window of bone just above the eye socket. After opening the dura (the brain’s covering), we go under the brain to find the blood vessels at the skull’s base. Using these blood vessels, we trace back to the aneurysm’s base. Once we find the aneurysm’s base or neck, we place a clip across it to prevent it from receiving blood flow from the parent vessel. This stops the aneurysm from filling with blood.
• Bypass Surgery:Creates a new pathway for blood flow around an aneurysm or blocked artery.

Endovascular Neurosurgery:

• Endovascular Coiling: This starts with a small needle stick in the wrist’s radial artery. We place catheters through the wrist, arm, and shoulder, navigating them to the brain’s blood vessels. Once inside the brain, we use a small catheter within a larger one to place platinum coils into the aneurysm. These coils prevent blood from entering the aneurysm and help it clot. Once clotted, the aneurysm can’t fill with new blood and is less likely to burst.
• Stenting: Involves placing a small mesh tube that keeps flow away from the aneurysm while keeping its  parent artery open.
• Embolization:Uses substances to block blood flow to an aneurysm or AVM.
• Radiosurgery:A non-invasive treatment using focused radiation to treat AVMs and cavernous malformations.

When deciding how to best treat an aneurysm, we consider factors such as the aneurysm’s size, location, and whether it has bled. Each patient receives a personalized treatment plan.

Our team, led by Dr Kassam, has pioneered open surgeries that can be performed with minimally invasive craniotomies in place of traditional surgeries. We can perform endovascular surgeries through small skin incisions, with “keyhole” and endoscopic techniques, to treat aneurysms. Endovascular techniques are less invasive but may require follow-up treatments.

Certain aneurysms near the brain’s surface are better suited for open surgery, while deeper aneurysms, like those in the basilar artery, are often safer with endovascular techniques. Younger patients, with longer life expectancies, may benefit more from open surgery due to its durability. Older patients may be better candidates for endovascular options due to the lower invasiveness and quicker recovery.

Intent Medical Group are fortunate to have state-of-the-art imaging suites, which perform angiograms during surgery to confirm there’s no longer blood flow into the aneurysm. If angiograms show blood flow remains, additional treatments are necessary.

Our extensive experience in complex vascular neurosurgery cases attracts patients from around the state and country. Our team of ICU nurses, doctors, advanced care practitioners, therapists, and case management staff are adept at handling difficult cases in vascular neurosurgery.

Our Approach to Care

The Intent Medical Group team takes a multidisciplinary approach, bringing together neurosurgeons, neurologists, radiologists, and specialized advanced care practitioners to create personalized treatment plans. We leverage the latest technologies and minimally invasive procedures with the goal of providing the highest standard of care while minimizing disruption to our patients’ lives.

Patient-Centered Support

We understand the emotional and physical challenges that come with cerebrovascular conditions. Our support services include case management, social work, mindfulness-based stress reduction classes, and spiritual care to help patients and their families navigate their journey with us.