Brain vascular diseases are life-threatening conditions resulting from structural abnormalities, blockages, or hemorrhages in the blood vessels supplying the brain. This group of diseases covers a wide range, from sudden stroke to silently growing aneurysms.
Brain Aneurysm (Balloon) and Its Treatment
A brain aneurysm is a balloon-like bulge that forms due to weakening of the blood vessel wall. The greatest risk is that this bulge may rupture, leading to subarachnoid hemorrhage.
Aneurysm Clipping (Open Surgery) Method
Microsurgical clipping is a procedure that involves placing a small, permanent metal clip on the neck of the aneurysm to prevent blood flow from entering the balloon. This method is one of the most reliable solutions, especially for wide-based aneurysms and those located at blood vessel branching points.
Endovascular Coiling (Closed Surgery)
Catheters inserted through the groin are used to reach the aneurysm inside the vessel, where platinum wires (coils) are placed inside it. This method is a minimally invasive option for aneurysms located in deep areas of the brain.
Cerebral Arteriovenous Malformation (AVM) and Intervention Techniques
Arteriovenous Malformation (AVM) refers to abnormal vascular malformations where arteries and veins are directly connected without a capillary network.
AVM Surgery: Our goal is to completely remove this vascular malformation without damaging healthy brain tissue.
Embolization: This procedure involves injecting special occlusive materials into the blood vessels to reduce blood flow to the AVM. It is often used as an adjunctive method to reduce the risk of bleeding before surgery.
Stroke Surgery and Emergency Intervention
Stroke is a condition caused by the interruption of blood flow to part of the brain and is a race against time.
Thrombectomy: Removal of Clots from Blood Vessels
In ischemic stroke, it is the process of removing the clot causing the blockage from the vessel using angiographic methods. Intervention within the first few hours can significantly reduce the risk of permanent paralysis.
Decompressive Craniectomy
Excessive edema in the brain following major strokes increases intracranial pressure. In such cases, the temporary removal of a portion of the skull bone allows the brain to breathe and helps the patient survive.
Treatment Methods Comparison Table
| Method | Application Method | Recovery Time | Key Advantage |
| Microsurgery (Open) | Craniotomy (Skull is opened) | 4-6 weeks | Provides definitive and permanent closure. |
| Endovascular (Closed) | Via catheter (through the blood vessel) | 3-7 days | No incision, allows for rapid discharge. |
| Interventional Thrombectomy | Clot removal under angiography guidance | Varies depending on the patient | Prevents functional loss in acute stroke. |
Recommendations from Prof. Dr. Erdinç Özek
“Time is the most crucial factor determining success in cerebrovascular diseases. When experiencing severe headache, speech impairment, or sudden onset of weakness, the ‘let’s wait and see’ approach can have life-threatening consequences. No matter how advanced our surgical techniques may be, preventive medicine and early intervention always yield the best outcomes. If there is a history of vascular disease in your family, I recommend getting screened without waiting for symptoms.”
Clinical Experiences and Case Example
Anonymous Case Analysis: A 52-year-old patient presented to the emergency department with sudden and severe pain, describing it as “the worst pain of my life.” Subarachnoid hemorrhage and a 6 mm aneurysm were detected. The patient underwent emergency surgery, and the aneurysm was successfully closed using a microsurgical clipping technique. Intraoperative angiography was used to monitor blood flow. Following intensive care and rehabilitation, the patient returned to work at the 3-month follow-up with no neurological deficits.
Postoperative Intensive Care and Rehabilitation
For the first 48 hours after vascular surgery, patients are monitored in advanced intensive care units due to the risk of “vasospasm” (vascular constriction). Early physical therapy is critical for regaining motor skills once the neurological condition has stabilized during the recovery process.
Frequently Asked Questions
Does a brain aneurysm always bleed?
Although not all aneurysms carry a risk of bleeding, they require regular monitoring or intervention due to the possibility of rupture depending on factors such as the size and shape of the aneurysm and the patient’s blood pressure.
Is endovascular surgery or open surgery better?
The treatment option is determined based on the location and structure of the aneurysm or vascular tangle and the patient’s general condition; both methods have their own advantages.
What is the risk of paralysis after brain vascular surgery?
Thanks to modern microsurgical techniques and neuromonitoring technology that monitors nerve function during surgery, the risk of operational stroke has been reduced to very low levels today.
Can a vascular malformation or aneurysm recur after surgery?
The risk of recurrence is very low in AVMs completely removed by microsurgery or in aneurysms successfully clipped; however, patients are advised not to neglect periodic check-ups regarding their vascular health.
How much time do we have for surgical intervention after a stroke?
In strokes caused by blockages, the principle of “time is brain” applies, and thrombectomy performed within the first 6-hour golden period is the most critical intervention opportunity to reverse brain damage.
How long does it take to recover after vascular surgery?
Patients can be discharged within a few days after closed (endovascular) procedures, while full recovery and return to social life after open surgical procedures generally requires a process of 4 to 6 weeks.
Detailed Information and Appointment
To protect your brain vascular health and evaluate modern surgical treatment options, you can contact Prof. Dr. Erdinç Özek’s clinic. You can schedule an appointment at our center in Istanbul to receive expert advice on risk analysis and treatment planning.
Scientific References
Stroke (AHA/ASA Journals): Guidelines for the Management of Spontaneous Intracerebral Hemorrhage. https://www.ahajournals.org/journal/str
The Lancet Neurology: Endovascular thrombectomy after stroke: 2026 perspectives. https://www.thelancet.com
PubMed (NIH): Microsurgical clipping vs endovascular coiling for intracranial aneurysms. https://pubmed.ncbi.nlm.nih.gov