At Penn Medicine, an expert team of neurosurgeons, neurologists, diagnostic and interventional neuroradiologists, neurointensivists, and neuroanesthesiologists provides highly specialized care for all aspects of cerebrovascular disease. In some cases, these conditions are treated with craniotomy (opening of the skull) followed by microsurgery, in which a neurosurgeon uses a highly specialized microscope and surgical instruments to identify the affected vessel (or vessels) and correct it.
Penn also specializes in a newer technique that does not require opening the skull--endovascular neurosurgery. Working closely with Penn’s interventional radiologists, neurosurgeons can insert a microcatheter through
a small incision in the femoral artery in the leg, or the brachial artery in the arm, and then thread it into the brain to access and treat the vessel problem or malformation. Endovascular techniques can make previously inaccessible areas of the brain accessible enabling Penn neurosurgeons to treat parts of the brain that were too dangerous to approach before.
Surgical Options for Neurovascular Disorders
Microsurgery is a general term for any surgery requiring an operating microscope. Neurovascular diseases can be treated by traditional, open surgery, using very small instruments and, a microscope (microsurgery). This type of surgery involves working around very small, delicate nerves and sections of the brain that must be treated gently and carefully to avoid complications. Microsurgery includes skull base surgery, neurovascular surgery and aneurysm clipping. Penn neurosurgeons use the latest
techniques in microsurgery combined with computer-guided
localization and sophisticated intraoperative monitoring to achieve
the best possible outcomes.
Endovascular surgery is a minimally-invasive procedure used to treat problems affecting the blood vessels, such as an aneurysm, which is a swelling or "ballooning" of the blood vessel. It requires a small incision and is performed "within" the artery (endovascular) through a catheter inserted into the blood stream at the groin and guided to the brain. Endovascular surgery results in less pain, shorter hospital stays and less risk of complication than traditional open surgery. Endovascular surgery includes coiling, stenting, angioplasty, and embolization.
Radiosurgery is surgery using radiation therapy. The Gamma Knife, is a type of radiosurgical tool used to treat brain disorders without having to make incisions by delivering beams of radiation to a specific area of the brain. At Penn, neurointerventional specialists including neurosurgeons and radiologists are able to deliver energy bursts to the site of the brain with pinpoint accuracy. Because of its accuracy and precision, the Gamma Knife is considered an effective and highly trusted form of treatment.
Research and Clinical Trials
Penn is currently involved in research to improve the treatment of cerebrovascular conditions. Our physicians and researchers are interested in understanding the mechanisms of aneurysm rupture so that neurosurgeons can better predict which ones are most dangerous. As more aneurysms are being picked up incidentally on MRI scans done for other reasons the need to distinguish non-threatening aneurysms from
those likely to rupture—and therefore in need of treatment—becomes more pressing.
Read more about our research and clinical trials.
Sophisticated Hybrid Operating Room
Penn Medicine offers a state-of-the-art hybrid operating room that combines the capabilities of a catheterization lab and the sterile environment of an operating room. The hybrid room contains surgical equipment and advanced imaging equipment needed for minimally invasive techniques. This allows Penn’s surgeons to perform traditional, open surgery and minimally invasive endovascular procedures on a patient without moving the patient or staging the case over days. If a complication arises in an endovascular procedure, our dual-trained surgeons can automatically convert the case into an open surgical procedure.
Neuro-Intensive Care Unit
When necessary, Penn's dedicated neuro-intensive care team provides sophisticated critical care at Penn's state-of-the-art neuro ICU. This Level I trauma center and acute brain injury center employs the latest multimodality monitoring techniques to care for patients with severe neurological injuries.
It is the most technologically advanced and sophisticated neuro-critical care unit in the nation, and is the only academic facility of its kind in the region.