ANOTHER REASON TO CHOOSE MAYAPADA HOSPITAL
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Neuro-vascular is a subspecialty field in Neurosurgery, divided
with early detection. In developed countries, ruptured aneu-
into two major categories: Microsurgery and Endovascular.
rysm has a low number of incidence. Early treatment of aneu-
Neuro-vascular abnormalities such as aneurysm, arteriovenous
rysm cases will give optimum result with short hospitalization
malformation (AVM), carotid artery abnormalities, hyperten-
days.
sion and ischemic stroke, and blood vessel tumor in the brain will decrease one's quality of life, causing neurologic disorder from disabilities to fatality. To detect blood vessel abnormalities in the brain, a non-invasive angiography can be done such as Magnetic Resonance Angiography (MRI) and Computed Tomography Angiography (CTA). Another option is to do an invasive endovascular procedure, such as Digital Subtraction Angiography (DSA). It will give better imaging and is the gold standard for vascular workup. A definitive procedure can be done following angiog
Giant Aneurysm
raphy
Neuro-vascular is growing rapidly in the last decade. Through endovascular procedure, aneurysm management can be done from a simple procedure such as simple coiling to balloon/stent assisted coiling and the latest technique of flow diversion. Flow diversion stands as an alternative procedure for giant aneurysm. Bypass is also an alternative that can be done following open surgery. Despite its advance technique, not all cases can be managed by endovascular. It depends on the morphology, location, perforating arteries involvement, durability, patient’s age and general condition. A neuro-vascular neurosurgeon will decide the best treatment for the patient, either with open surgery and clipping or endovascular procedure with coilArteriovenous Malformation (AVM)
ing.
Ruptured aneurysm is one of the most common cause of death
In AVM cases, embolization can be done by endovascular pro-
in neurosurgery. According to the Brain Aneurysm Foundation,
cedure before Open Resection Surgery or Stereotactic Radio-
there are 500.000 deaths per year in the world, half of them are
surgery. Deep situated AVM will usually undergone Stereotac-
under 50 years of age. Whereas 60% of ruptured aneurysm
tic Radiosurgery whereas superficial AVM is best done by
cases will have disabilities. These numbers can be lowered 66 | FORBES INDONESIA FEBRUARY 2018