Neurovascular Disorders

The neurologists and neurosurgeons at Torrance Memorial Medical Center’s Lundquist Neurosciences Institute offer expert urgent and long-term care for neurovascular disorders that affect the blood supply to your brain or spinal cord. Our affiliation with the neurology and neurosurgery team at Cedars-Sinai — which is ranked among the best hospitals in the nation for neurology and neurosurgery care by U.S. News & World Report — means that our patients have access to some of the nation’s top doctors, the most promising clinical trials, and the latest and best treatments.

What is a Neurovascular Disorder?

A neurovascular disorder is a condition that affects the blood supply in the brain or spinal cord. Blood flow may be affected by:

Narrowing, hardening, or abnormality of the blood vessels
A blockage caused by a clot or embolism
A hemorrhage, or bleeding from a ruptured blood vessel

Neurovascular disorders include:

Acute subdural hematoma
Arterial cranio-cervical trauma
Arteriovenous fistula (cerebral or spinal)
Arteriovenous malformation (AVM)
Carotid artery dissection
Carotid artery stenosis
Carotid body tumors
Cavernous malformation
Cerebral (brain) aneurysms
Cerebral arteriovenous malformations
Cerebral contusion
Fibromuscular dysplasia
Intracerebral hematoma
Intracranial arterial stenosis
Moyamoya disease
Non-ruptured brain aneurysms
Spinal arteriovenous malformation
Subdural hematoma
Vertebral artery dissection
Vertebral artery stenosis

Symptoms

Some neurovascular conditions do not cause symptoms in their early stages, but symptoms may begin to appear as the condition gets worse or changes. Other neurovascular conditions cause sudden, severe symptoms that require emergency treatment and may lead to disability or death.

Symptoms of neurovascular conditions may include:

Trouble walking or keeping balance
Loss of coordination and feeling dizzy
Confusion or change in mental status
Inability to speak or understand speech
Numbness, weakness, or paralysis in the face or arms, especially if only on one side of the body
Difficulty seeing through one or both eyes
Hearing difficulties or changes, such as ringing in the ears
Sudden, severe headache
Stiff neck
Nausea or vomiting
Loss of consciousness
Seizure
Collapse

Causes & Risk Factors

Experts are not sure what causes neurovascular disease, but people who have a personal or family history of heart disease, diabetes, high cholesterol, or smoking may be at greater risk.

Diagnosis

To diagnose a neurovascular disorder, your doctor will review your medical history, evaluate your symptoms, and perform exams or order tests, including:

Physical exam. During your physical exam, your doctor will assess your balance, coordination, and mental alertness. Your doctor will also check for other symptoms, such as numbness, weakness, or paralysis in your legs, arms, or face.
Computed tomography (CT) scan. Your doctor may order a CT scan of your brain to determine if there is bleeding, a blockage, or other abnormalities.
Magnetic resonance imaging (MRI). An MRI uses radio waves and magnetic fields to create detailed images of your body. An MRI of your brain may be ordered to determine if there are abnormalities in your brain.
Carotid ultrasound. Carotid ultrasound uses sound waves to create detailed images of your carotid arteries in your neck, which supply blood to your brain. A carotid ultrasound can show plaque buildup or blockage of your carotid arteries.
Cerebral or carotid angiogram. Your doctor will make a small incision leading to one of your arteries, usually in your thigh. Your doctor will then insert a small hollow tube called a catheter into your artery and guide the catheter to the major arteries in your neck. Once in position, your doctor will inject a dye that makes the arteries in your neck and/or brain visible under x-ray imaging to check for signs of hemorrhaging or blockage.
Blood test. Your doctor may order blood tests to determine the time it takes your blood to clot, assess whether you have an infection, and monitor your blood sugar.

Treatment

Your treatment will depend on the type of neurovascular disorder you have. Treatment may include:

Medication. Tissue plasminogen activator (tPA) breaks apart clots and restores blood flow to your brain. Depending on your condition, your healthcare provider may also prescribe anticoagulants (blood thinners), antiplatelet medicine, or other medications to control symptoms.
Intra-arterial thrombolysis. During this procedure, a long, flexible tube, or catheter, is inserted through an artery in your groin to deliver a clot-busting medicine directly to the area where a blood clot is located.
Mechanical clot removal in cerebral ischemia (MERCI). During MERCI, a catheter carrying a small device is threaded through a carotid artery to physically remove a blood clot and restore blood flow.
Carotid endarterectomy. Carotid endarterectomy is a surgical procedure to remove plaque from inside your carotid artery through an incision in your neck.
Carotid angioplasty and stenting. During this procedure, a catheter is threaded through an artery, usually in your groin, and guided to the site of the blockage in your carotid artery. Once in place, your doctor will inflate a balloon to widen your artery and restore blood flow. A small, hollow tube called a stent will then be placed to keep your artery open.
Cerebral artery bypass. Cerebral artery bypass is a surgical procedure that uses a small blood vessel from another part of your body to create a path around a blockage in an artery in your brain.
Stereotactic radiosurgery. Stereotactic radiosurgery delivers a single, high dose of radiation to close off blood vessels. It is often used to treat AVM and cavernous malformation.
Endovascular embolization (coiling). Endovascular coiling plugs or blocks a ruptured aneurysm using small metal coil.
Embolization. Embolization involves the injection of a glue-like material to block abnormal arteries.
Surgical clipping. During this procedure, a clip is placed on an aneurysm to stop blood flow.
Surgical AVM and cavernous malformation removal and repair. This procedure is used to remove AVM or cavernous malformations and fix the deformities in your blood vessels that caused the conditions to develop.
Surgical procedures for moyamoya. Our surgeons use the latest surgical methods to bypass blockages caused by moyamoya disease and promote the development of new blood vessels.