Treatments for Vascular Malformations of the Brain
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 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.
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.
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.
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.