My brother is 28 years old, recently had a headache, dizziness, nausea..., suspected of being at risk of stroke.
He went for an MRI and DSA scan and found a cerebral vascular malformation (arteriovenous fistula in the posterior fossa) with a 3.5 mm pseudoaneurysm. Doctor, when is it necessary to use X-rays for cerebral vascular malformations and when is it necessary to intervene and perform robotic brain surgery? (Ly Nguyen, Ho Chi Minh City)
Reply:
Currently, there are 3 common methods of treating cerebral arteriovenous malformations: open craniotomy, vascular intervention and gamma knife. Depending on each case, the doctor will consider choosing the appropriate treatment method. The main goal is to prevent bleeding, and at the same time to control seizures or other neurological complications.
Endovascular intervention : This technique is performed by a neurovascular interventionist on a digital subtraction angiography (DSA) machine. At Tam Anh Hospital, Ho Chi Minh City, this method has been successfully applied to many cases of cerebral vascular malformations. A small catheter of about 2 mm is inserted into the femoral artery and threaded through the blood vessels to the brain using X-ray, CT or MRI images fused into DSA.
Through the catheter, the surgeon will inject an embolic agent to block the artery and reduce blood flow to the malformed blood vessel. Endovascular intervention is a minimally invasive treatment that helps remove or reduce the size of the aneurysm, reducing the possibility of bleeding causing a hemorrhagic stroke. After endovascular intervention, the patient will be examined to re-evaluate the malformation. From there, the doctors will have a direction for further treatment.
Typically, for cases with vascular malformations smaller than 3 cm and simple structures, embolization may be the treatment of choice. Larger malformations and complex structures are often treated with a combination of methods. In these cases, doctors often embolize first to reduce the size of the malformation.
Gamma Knife Radiosurgery : Gamma Knife radiosurgery is an interventional method mainly applied to small vascular malformations (less than 3.5 cm) that are high-risk or complicated to operate on. Gamma Knife radiosurgery is a safe and effective treatment option, helping to remove the malformation and prevent the risk of brain hemorrhage. This method also helps to reduce radiation-induced complications to a minimum.
For complex cases of cerebral vascular malformations, doctors will use multimodal treatment by combining methods together to achieve the best results for the patient.
Surgery to remove the malformation: If the cerebral arteriovenous malformation has bled (hemorrhaged) or is in an easily accessible area, brain surgery to remove the malformation is often the preferred method. In this case, the surgeon temporarily opens a part of the skull to access and remove the cerebral vascular malformation. Recently, at Tam Anh General Hospital in Ho Chi Minh City, neurosurgeons have applied the new generation Modus V Synaptive artificial intelligence robot, helping to operate on many cases of brain tumors, cerebral vascular malformations, and cerebral hemorrhage in the most difficult locations, with minimal invasion, bringing good results for patients.
Doctors at Tam Anh General Hospital perform brain surgery with the assistance of a robot. Photo: Provided by the hospital
Using a high-powered microscope, the surgeon will clamp the AVM with special forceps and carefully remove it from the surrounding brain tissue. The surgeon will then reattach the skull and close the incision in the scalp. Excision is usually performed when the AVM can be removed without damaging the functional area of the brain.
MSc.MD.CKII Mai Hoang Vu
Department of Neurosurgery, Tam Anh General Hospital, Ho Chi Minh City
| In order to update the latest information on brain tumor surgery techniques, cerebral hemorrhage stroke, cerebral vascular malformations... using the only artificial intelligence robot Modus V Synaptive in Vietnam, Tam Anh General Hospital System organizes an online consultation week on VnExpress newspaper. The program takes place from June 8-14, readers can follow and ask questions here to get answers from doctors. |
Source link
Comment (0)