Interventional neurology is a medical specialty that uses minimally invasive surgical techniques to diagnose and treat several conditions of the brain, spine and nervous system. These procedures are performed using imaging guidance such as X-rays, CT scans or MRI scans to help navigate precise anatomical targets. Interventional neurologists receive specialized training in neuroanatomy as well as image-guided surgical techniques to perform these procedures.
Common Procedures in Interventional Neurology
Some of the most common procedures performed by interventional neurologists include:
– Treating Brain Aneurysms
A brain aneurysm is a bulge or ballooning in a blood vessel in the brain. Left untreated, brain aneurysms can rupture and cause a stroke. Interventional neurologists are able to treat brain aneurysms using minimally invasive endovascular coiling or stent placement. This involves threading a thin catheter through the leg arteries all the way up to the brain. Then the aneurysm is injected with tiny platinum coils or covered with a stent to prevent it from rupturing.
– Removing Blood Clots of Stroke
In the case of an acute ischemic stroke caused by a blood clot blocking an artery in the brain, interventional neurologists may perform a thrombectomy. This intricate procedure utilizes a catheter with a stent retriever device. It is inserted through the groin artery and navigated up into the brain where it is used to capture and extract the clot causing the stroke. Removing the clot quickly can significantly improve outcomes for patients.
– Treating Herniated or Bulging Disks
Herniated or bulging disks in the spine can press on nerves and cause severe back and leg pain. Interventional neurologists are able to treat these non-surgically using specialized techniques like epidural steroid injections or nerve root blocks to reduce inflammation and pressure on the nerves. Procedures like facet joint injections target other areas to help relieve back pain.
– Treating Trigeminal Neuralgia
Trigeminal neuralgia causes severe facial pain and is often triggered by something as simple as brushing your teeth or getting your hair washed. When medication is no longer effective, radiofrequency rhizotomy can be done to disable the trigeminal nerve and relieve symptoms. Using imaging guidance, the interventional neurologist locates the trigeminal nerve and uses radio waves to heat and deaden a small portion of the nerve.
– Vertebroplasty and Kyphoplasty
These two procedures are performed to treat painful vertebral compression fractures of the spine. Through a small insertion in the back, cement is injected into the fractured vertebra during either vertebroplasty or kyphoplasty to reinforce and support the weakened bone. This provides prompt pain relief and can prevent further collapse of the vertebrae.
Diagnostic Tests Assisted by Interventional Neurology
In addition to treatments, interventional neurologists also perform several types of minimally invasive diagnostic procedures including:
– Lumbar Puncture
Also known as a spinal tap, a lumbar puncture involves inserting a small needle between the bones of the lower spine to collect a sample of cerebrospinal fluid (CSF). Analysis of CSF helps diagnose neurological conditions like meningitis.
– Nerve & Muscle Biopsies
Precisely guided needle biopsies of affected nerves or muscles under imaging can help diagnose conditions causing muscle weakness or neurological symptoms like amyotrophic lateral sclerosis (ALS).
– Intra-Arterial Digital Subtraction Angiography
This type of angiogram utilizes an iodine contrast dye and special X-ray images to visualize blood vessels in high detail. It is commonly used when planning treatments for aneurysms or arteriovenous malformations (AVMs) in the brain.
Benefits of Minimally Invasive Interventional Neurology
The major advantage of minimally invasive procedures in neurology is that they provide targeted treatment without requiring general anesthesia or open surgery. This translates to:
– Less trauma to the brain, spine and nerves compared to traditional open surgery
– Shorter hospital stays and faster recovery times for patients
– Procedures can often be performed on an outpatient basis
– Increased safety for high-risk patients who may not tolerate anesthesia or extensive surgery
– Ability to treat conditions not amenable to surgery, like most brain aneurysms
– Repeated treatments are possible if needed without significant risk of side effects
– Combining diagnosis and treatment in one minimally invasive session whenever feasible
As imaging and catheter technology continues to advance, the scope of interventional neurology will keep expanding to include more complex treatments previously only possible via open surgery. Overall, these techniques allow neurology patients to obtain effective care through small access points with minimized risks.
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1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it