What is vascular neurosurgery?

Written by: Dr Stuart Coley
Published: | Updated: 02/11/2023
Edited by: Sophie Kennedy

Vascular neurosurgery is a complex subspecialty that treats injuries related to haemorrhages or strokes in the brain or spinal cord. In this informative guide, revered radiologist Dr Stuart Coley explains more about some of the conditions which fall under this subspeciality and how they are treated.

What is vascular neurosurgery?

In general, vascular neurosurgery covers arterial aneurysms, vascular malformations and dural arteriovenous fistulas. It also treats cavernomas, which are midway between vascular and tumoural lesions, and some diseases that can cause cerebral infarctions. Here is a brief summary of some of the conditions treated by vascular neurosurgery:

Cerebral aneurysms

A cerebral aneurysm (also known as an intracranial or intracerebral aneurysm) is a weak or thin spot on a blood vessel in the brain that swells as it fills with blood. They can be diagnosed by chance in the course of a study for another condition or be symptomatic.

When symptomatic, cerebral aneurysms should be treated either by microsurgery or by endovascular treatment. The aim is to remove the aneurysm entirely from circulation. For asymptomatic cerebral aneurysms, due to the risk of rupture, those that have demonstrated growth or that are irregular should be treated. It is imperative that a cerebral aneurysm is evaluated by a neurosurgeon with extensive experience.

Arteriovenous malformations

Most arteriovenous malformations are diagnosed after bleeding occurs. In these cases, it is essential that the patient is treated by a very experienced neurosurgeon, since the surgical treatment of cerebral and spinal malformations is possibly the most complicated in neurosurgery. The most appropriate treatment will depend on the malformation’s location and size and the age of the patient.

Arteriovenous fistulas

Depending on the location (cranial / spinal) of the arteriovenous fistula, a surgical or endovascular treatment can be performed for ductus types. Arteriovenous fistulas in the spine are usually best resolved through surgery.


A cavernoma is a cluster of irregular blood vessels, usually found in the brain and spinal cord. They are treated using surgery.

To schedule a consultation with Dr Coley, visit his Top Doctors profile. 

By Dr Stuart Coley

Dr Stuart Coley is a radiologist based in Sheffield at the Thornbury Radiosurgery Centre. He specialises in Gamma Knife, stroke and aneurism imaging as well as angiography, diagnostic neuroimaging and cerebrovascular malformation imaging

The Thornbury Radiosurgery Centre is one of two national centres of excellence specialising in stereotactic radiosurgery treating patients suffering from a range of neurological conditions. The team at the clinic is made up of leading neurosurgeons, oncologists, neuro-radiologists who have specialist expertise in Gamma Knife surgery. 

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