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What is Vascular Neurology?

Vascular neurology is a medical specialty that treats neurovascular conditions. Neurovascular conditions, also called cerebrovascular conditions, cause brain damage due to an abnormality in the neurovascular system. The neurovascular system transports oxygen from the lungs to the brain, so disrupted blood vessels in the neural (brain) region may have critical consequences to an individual's physical and mental health. Strokes and brain aneurysms (bulging or blocked brain vessels) can both lead to subarachnoid hemorrhages, or leaking blood in the brain. Vascular neurologists treat these conditions through medicine and post-surgery care. Vascular neurologists are physicians with additional training in vascular neurology and may treat the following conditions that interfere with the structure and function of neural blood vessels:

• Stroke, the most common of neurovascular conditions
• Transient ischemic attack (TIA), a mini-stroke
• Brain aneurysm, bulging or blocked blood vessels in the brain
• Traumatic brain or spinal cord injuries
• Cavernous or arteriovenous malformations (irregularly formed blood vessels)
• Hematoma, a buildup of blood in the outer layer of the brain
• Moyamoya disease, a rare disease causing arterial blood blockages

Neurovascular disorders can be diagnosed through a variety of radiological imaging techniques, including CT and MRI scans, as well as single photon emission computerized tomography (SPECT). Electroencephalography (EEG) tests, which may measure brain activity, may also reveal neurovascular damage. Certain symptoms such as stroke or seizure can indicate the presence of a neurovascular condition. When a neurovascular abnormality is discovered, a vascular neurologist may develop a treatment plan to help patients prevent, manage, or recover from the neurovascular condition. While vascular neurologists do not perform surgery, they will refer and direct patients to a vascular surgeon and provide post-operative care. Vascular neurologists may perform or order the following procedures:

• Lumbar puncture (spinal tap), where cerebrospinal fluid (CSF) is withdrawn through a needle, or medicine is injected
• Prescribe oral medications, such as warfarin, which thin the blood to prevent clots and blockages
• Neurovascular surgery, such as through a craniotomy (portion of the skull is cut)
• Vascular stereotactic radiosurgery, where radiation beams may shrink blood vessels
• Implantation of an intracranial pressure sensor, where a sensor might alert a vascular neurologist of an imminent neurovascular condition

If left untreated, certain neurovascular conditions may cause permanent mental or physical impairment. Vascular neurologists may continue to treat patients before, during, and after surgical treatments and through rehabilitative stay. Vascular neurologists may collaborate with neurologists, neuroradiologists, and vascular surgeons.