Frameless Stereotaxis

Computer guidance is used without a head frame to localize intracranial lesions with up to a 1-2mm accuracy.

Frame-based Stereotaxis

A head frame is attached to the skull and computer guidance is used to remove very small vascular malformations.

Angiography

During an angiogram, regular x-rays take a picture as a medication is injected directly into the artery, outlining the vessel's interior. The resulting angiogram is the most accurate way of looking at arteries in the neck, head and brain, and provides information that cannot be obtained with other tests. It is often used to determine the amount of blockage in an artery in the neck. It is also used to detect the location and size of aneurysms and vascular malformations. This is an invasive test, requiring a physician to insert a catheter into the major artery near the groin and direct it 'upstream' to the arteries near the brain. In experienced hands the risk of this procedure is a stroke which can happen in about 1 per thousand patients.

Intracranial Bypass

Like heart bypass surgery, small arteries or veins are used to bypass vascular lesions or provide additional blood flow to the brain in patients with occluded arteries.

Gamma Knife Radiosurgery

Radiosurgery is not surgery in the conventional sense, as it does not require an incision. Instead, high-energy beams of radiation are directed at the target in the brain with the aim of destroying that tissue. As a result, the patient may enjoy many of the benefits of surgery, often with reduced risk, and without a prolonged convalescence and incision pain. Several types of radiosurgery are practiced, the most common of which focus converging beams of radiation at the target point (so-called focused beam radiation) while beams of ions (heavy particle radiosurgery) can also be used as they deposit their energy and the destructive power at predictable depths below the surface. There are two common methods of focused beam radiosurgery - linear accelerator radiosurgery and Gamma Knife radiosurgery. Although there are many similarities, there are also important distinctions. Radiosurgery can be used to treat some malignant or benign brain tumors, arteriovenous malformations, certain types of facial pain such as trigeminal neuralgia, and may have a role in the management of Parkinson's disease and other disorders of the brain.

Endovascular Coiling

Under anesthesia, a small catheter is placed in the aneurysm via the artery in the groin and small platinum coils are packed inside to occlude it.

AVM Embolization

A small catheter is passed through the groin and into an artery feeding the AVM where glue or particles are used to partially or completely occlude the lesion.