Surgery can be used to prevent stroke, to treat stroke, or to repair damage to the blood vessels or malformations in and around the brain. The two most common types of surgery to prevent and treat stroke are carotid endarterectomy and extracranial/intracranial or EC/IC bypass. Extracranial refers to the area outside the cranium, or skull, and intracranial refers to the area inside the skull.
Carotid Endarterectomy
Carotid endarterectomy is a surgical procedure in which a doctor removes fatty deposits, or plaque, from the inside of one of the carotid arteries. The procedure is performed to prevent stroke. The carotid arteries are located in the neck and are the main suppliers of blood to the brain.
EC/IC Bypass Surgery
EC/IC bypass surgery is a procedure that restores blood flow to a blood-deprived area of brain tissue. The surgeon reroutes a healthy artery in the scalp to the area of brain tissue affected by a blocked artery.
A few years ago the National Institute of Neurological Disorders and Stroke at the National Institutes of Health sponsored a study to test the ability of EC/IC bypass surgery to prevent recurrent or additional strokes in stroke patients with atherosclerosis, or hardening of the arteries.
The study showed that, in the long run, EC/IC does not seem to benefit these patients. The surgery is still performed occasionally for patients with an aneurysm, which is a weak or thin spot that develops on the wall of an artery or vein. Sometimes, doctors also perform EC/IC bypass on patients with some types of small artery disease or certain blood vessel abnormalities.
Aneurysm Clipping
One useful surgical procedure for treatment of brain aneurysms that can cause hemorrhage, or bleeding, is a technique called "clipping." Clipping involves clamping off the aneurysm from the blood vessel, which reduces the chance that it will burst and bleed.
The detachable coil technique is a new therapy to treat high-risk intracranial aneurysms, or aneurysms that occur inside the skull. A small platinum coil is inserted through an artery in the thigh and threaded through the arteries to the site of the aneurysm. The coil is then released into the aneurysm, where it triggers an immune response from the body.
The National Institute on Aging (NIA), one of the 27 Institutes and Centers of the National Institute of Health (NIH) leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life.