Weill Medical College of Cornell University

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• Acute Stroke Revascularization
• Aneurysm Treatment
• Arteriovenous Malformation Closure
• Carotid Angioplasty and Stenting
• Cerebrospinal Angiography
• Retinoblastoma Treatment
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Aneurysm Treatment

An aneurysm is a weak part on a blood vessel wall (like a blister or blowout on a tire). Aneurysms may come to medical attention after they rupture or may be found incidentally after routine brain imaging such as a CT scan or an MRI. Aneurysms found after rupture must be treated, with either open microneurosurgical clipping or minimally invasive endovascular coiling. Both techniques have been highly successful in treating ruptured brain aneurysms. Unruptured aneurysms should be evaluated but not all aneurysms will need to be treated. This can usually be determined with newer types of vascular imaging studies. However, occasionally, cerebral angiography may be required.

Diagnosis

At Weill Cornell, patients with symptoms of aneurysm undergo an extensive evaluation by a team of nuerosurgeons, neurologists, and neuroradiologists. Based on this assessment a course of treatment is recommended. As a leading center for treatment of intracranial aneurysms, Weill Cornell uses many innovative techniques to evaluate and treat these lesions. Patients are cared for in a state-of-the-art neurological intensive care unit and monitored closely for symptoms of cerebral vasospasm (a condition that can cause stroke following the rupture of an aneurysm) and hydrocephalus (increase in the size of the fluid spaces of the brain secondary to aneurysm rupture).

Treatment

If it is determined that a patients aneurysm requires treatment there are typically three treatment options: open microneurosurgical clipping, minimally invasive endovascular coiling, and lastly, a combined approach.

• Microneurosurgical treatment of aneurysms involves placing a tiny metal clip at the aneurysm's base to prevent entry of blood into the vessels weakened area.
• Neuroendovascular treatment is the minimally invasive placement of tiny coils directly into the aneurysm, which promotes thrombosis and potential healing of the aneurysm and eliminates the possibility of future rupture.
• A combined surgical and neuroendovascular treatment is considered for complex aneurysms. The two approaches are used to complement each other for the safe obliteration of the aneurysm.