Each year, stroke impacts approximately 750,000 to 800,000 individuals in the United States, taking a tremendous toll on these patients, their families, and society in general. A major cause of disability, many stroke survivors are left with significant speech, motor, and memory difficulties and more than half of them can't return to work.
Stroke occurs when the blood flow to a part of the brain stops, usually due to a blood clot or clogged arteries or because a weak blood vessel ruptures as in an aneurysm or moyamoya disease. In rare cases, a patient may have abnormalities in the veins and arteries called arteriovenous malformations (AVMs), cavernous malformations, or dural arteriovenous fistulas (DAVFs) that rupture. Stroke is a serious condition needing immediate treatment for optimal recovery.
At Brigham and Women's certified Comprehensive Stroke Center, our multidisciplinary team of specialists uses advanced diagnostic capabilities to determine the best treatment approach for the individual patient. The Center's stroke treatment options include medical, endovascular, and surgical therapies, often given in combination.
Medical and endovascular treatments for stroke include intravenous and intra-arterial thrombolysis to break up blood clots. Identification of and medical treatment of underlying causes and risk factors can help reduce further stroke risk.
Neurosurgical procedures, including brain aneurysm surgery, may also be performed as part of stroke treatment. These procedures may include:
Carotid endarterectomy and other neurosurgical approaches to prevent stroke or recurrence of stroke while minimizing injury to normal brain tissue
Craniectomy and hemispheric decompression for stroke patients with a large area of brain affected
Microsurgery to treat aneurysms, AVMs, DAVFs, and cavernous malformations
Extracranial to intracranial bypass procedures for obstructed vessels and moyamoya disease
Minimally invasive procedures such as coil embolization of aneurysms
Microcatheter embolic injection to fill malformations and decrease the risk of dangerous bleeding in patients with intracranial vascular malformations
For patients with acute neurological conditions, including stroke, the 20-bed Neuroscience Intensive Care Unit provides dedicated care and treatment by neurologists, neurosurgeons, and other specialists. For those patients with serious, life-threatening neurologic and cardiac emergencies, our Emergency Cardiac Neuro Unit (ECNU) provides rapid response care.
In this video, Dr. Ali Aziz-Sultan, Chief of Vascular/Endovascular Neurosurgery in the Department of Neurosurgery at Brigham and Women’s Hospital, outlines the different types of strokes and the newest stroke treatment options that are designed to minimize the long-term effects of stroke. He also discusses the benefits of hybrid environments that enable both open and minimally invasive stroke treatment for ischemic and hemorrhagic strokes, in one setting. Read the Innovative and Minimally Invasive Treatments for Stroke and Brain Aneurysm Patients video transcript.
The Neurosciences Center at BWH: innovative neurological and neurosurgical services
The Stroke and Cerebrovascular Center is part of the Neurosciences Center at BWH, which offers many innovative and advanced therapies for all diseases of the nervous system, including stroke. The center also includes Boston neurology and Boston neurosurgery, delivering state-of-the-art treatment through many innovative techniques to improve outcomes for patients with neurological conditions. The center has one of the largest and most specialized clinical teams of neurosurgeons, psychiatrists and radiologists available anywhere.
Pioneering research in treatment for stroke
The Stroke and Cerebrovascular Center at BWH has extensive research underway, including many NIH-funded studies aimed at developing new treatment for stroke and cerebrovascular disease.