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Neurological Surgery: Neurovascular Disorders

TREATMENT SPECIALISTS AND COMMONLY ASKED QUESTIONS ABOUT THE NEUROVASCULAR PROGRAM

The Washington University neurovascular program at Barnes-Jewish Hospital provides multidisciplinary evaluation and clinical management of patients with neurovascular disorders. Using the latest therapeutic management strategies and state-of-the-art diagnostic imaging, our specialists treat patients in the most technologically advanced facility in the region.

FOR AN APPOINTMENT, CALL (314) 362-3570

Ralph G. Dacey Jr., M.D., neurosurgeon-in-chief
Michael R. Chicoine, M.D., neurosurgeon
Keith Rich, M.D., neurosurgeon
Gregory J. Zipfel, M.D., neurosurgeon
DeWitte Cross III, M.D., neuroradiologist
Colin Derdeyn, M.D., neuroradiologist
Christopher Moran, M.D., neuroradiologist

The multidisciplinary team of neurologists, neurosurgeons and neuroradiologists treat the full range of neurovascular disorders including: aneurysms, arteriovenous malformations (AVMs), carotid cavernous fistulas, carotid, vertebral and cerebral arterial stenoses, strokes and vascular tumors

Therapeutic management of neurovascular disorders include both neurosurgical and endovascular techniques, as follows:

Neurosurgical Techniques

  • Aneurysms: microsurgical repair, performed in conjunction with intraoperative angiography for real-time assessment
  • AVMs: microsurgical resection, functional cortical localization, computerized surgical navigation
  • Cerebrovascular stenoses: endarterectomy and bypass procedures

    Endovascular Techniques

  • Aneurysms: GDC (Guglielmi detachable coil) treatment
  • AVMs: embolization
  • Carotid cavernous fistulas: transarterial or transvenous occlusions
  • Cerebrovascular stenoses: angioplasty, stenting
  • Strokes: intra-arterial thrombolysis
  • Vascular tumors: embolization, novel intra-arterial chemotherapy techniques
  • Vasospasm: endovascular management using balloon angioplasty or drug infusion
  • Spinal malformations: spinal angiography and embolization

    Stereotactic Radiosurgery

  • AVMs: Gamma Knife
  • Vascular tumors: Gamma Knife

    What is the Washington University advantage?

    First, our patients benefit from the skill of the highly specialized and experienced physicians, who perform more than 1,100 cerebral angiographies and 200-300 neurointerventional procedures each year.

    Second, we have available the full spectrum of diagnostic imaging technology, including two Siemens machines designed specifically for cerebral angiography

    Third, Barnes-Jewish Hospital offers patients the most advanced facilities in the region, such as the 20-bed Neurology-Neurosurgery Intensive Care Unit, which serves more than 1,000 patients each year

    And last, our facilities include state-of-the-art operating rooms with three Contraves-Zeiss operating microscopes, a dedicated team of neurovascular operating room nurses, intraoperative angiography and stealth surgical navigation.

    What is the evaluation process?

    All patients referred to the Neurovascular Program at Washington University School of Medicine receive an initial evaluation by one of the clinical team members. Each case is discussed in detail at the weekly joint neurovascular conference, and the appropriate treatment option is initiated.

    What about research?

    One of the benefits of seeking treatment from a medical center such as ours is the opportunity to participate in unique clinical research protocols. This can provide patients access to the latest techniques and therapies available.

    Current research projects include: the control of reactivity of the cerebral blood vessel wall; the use of positron emission tomography (PET) for understanding cerebrovascular disease; the development of novel endovascular techniques; and the development of new drug delivery techniques and embolic materials for treatment of aneurysms.

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    Copyright 2010 Washington University School of Medicine
    Copyright 2010 Washington University School of Medicine