Vascular and Endovascular Neurosurgery

Vascular and Endovascular Neurosurgery Neuro/Spine surgeon and Endovascular Neurosurgeon. SPARSH HOSPITAL
YELAHANKA BRANCH
BANGALORE Kindly read the contents as it may be useful to your beloved ones.

This page will be dedicated to brain vascular diseases and their evidence based management as of today. This is an attempt to create general awareness to public on vascular diseases of brain and their management. Early detection and treatment may prevent some of the major complications. All the uploads will be in simplified layman language with some of the studies being quoted as a evidence for treatment.

Case of the Week 🧠⚡A 43-year-old female presented with recurrent TIAs (4 episodes) along with a recent minor stroke, rai...
09/04/2026

Case of the Week 🧠⚡
A 43-year-old female presented with recurrent TIAs (4 episodes) along with a recent minor stroke, raising concern for an evolving cerebrovascular event.
Neuroimaging revealed a critical stenosis of the distal intracranial ICA, significantly compromising cerebral perfusion.
Given the high risk of a major stroke, a timely decision was made—after detailed discussions with the family—to proceed with intracranial ICA balloon angioplasty and stenting.
✨ Outcome: • Smooth and uneventful procedure
• Marked improvement in cerebral circulation
• No new neurological deficits
• Patient recovering well
This case highlights the importance of early recognition and proactive endovascular management in preventing disabling strokes.
Intervening at the right time can make all the difference.

Endovascular Management of ACom AneurysmsSharing two cases of aneurysmal subarachnoid hemorrhage (SAH) successfully tre...
11/03/2026

Endovascular Management of ACom Aneurysms

Sharing two cases of aneurysmal subarachnoid hemorrhage (SAH) successfully treated with endovascular coiling.

Case 1:
A 40-year-old male presented with acute SAH (WFNS Grade 1). Cerebral angiography revealed an anterior communicating artery (ACom) aneurysm. He underwent uneventful endovascular simple coiling, achieving complete aneurysm occlusion with no additional neurological deficits. The patient recovered well.

Case 2:
A 54-year-old female presented with aneurysmal SAH. She underwent successful endovascular coiling of the aneurysm, with smooth intra-operative and post-operative recovery and no new neurological deficits.

These cases highlight the effectiveness and safety of endovascular techniques in managing ruptured intracranial aneurysms, offering minimally invasive treatment with excellent outcomes when performed promptly.

🧠 Timely diagnosis and intervention remain key in improving outcomes in SAH.







Cases of the Week 🧠Case 1:A 40-year-old male presented with sudden onset altered sensorium, breathing difficulty with st...
06/03/2026

Cases of the Week 🧠
Case 1:
A 40-year-old male presented with sudden onset altered sensorium, breathing difficulty with stridor, and right-sided limb weakness. Emergency imaging revealed an acute basilar artery stroke, a life-threatening condition requiring immediate intervention.
He was taken up for emergency mechanical thrombectomy, and the blocked vessel was successfully recanalized within 2 hours. The patient showed remarkable neurological recovery with near-normal function following the procedure.
Case 2:
A 60-year-old lady presented with repeated transient ischemic attacks (TIAs). Further evaluation revealed critical stenosis of the left internal carotid artery (ICA), putting her at high risk for a major stroke.
She underwent carotid artery stenting, which was completed uneventfully with successful restoration of blood flow.
These cases highlight the importance of early diagnosis and timely endovascular intervention in preventing devastating neurological outcomes and saving lives.

Pre-operative Tumour Embolization in CP Angle TumoursSharing two cases of cerebellopontine angle tumours — Glomus jugula...
27/02/2026

Pre-operative Tumour Embolization in CP Angle Tumours
Sharing two cases of cerebellopontine angle tumours — Glomus jugulare tumor — managed with pre-operative endovascular embolization prior to definitive surgical excision.
Glomus jugulare tumours are highly vascular skull-base lesions. Pre-operative embolization allows selective occlusion of feeding arteries, significantly reducing tumour vascularity.
Key advantages:
🔹 Improved surgical visualization
🔹 Reduced intraoperative blood loss
🔹 Shorter operative time
🔹 Safer and more controlled tumour excision
This important adjunct enhances surgical safety and optimizes outcomes in complex skull-base tumour surgery.

When Minutes Decide Life: Two Acute Basilar Artery Stroke RescuesBasilar artery stroke is among the most devastating neu...
23/02/2026

When Minutes Decide Life: Two Acute Basilar Artery Stroke Rescues
Basilar artery stroke is among the most devastating neurological emergencies, with extremely high mortality and disability if circulation is not restored immediately.
Case 1
A 60-year-old gentleman was brought to the emergency department with sudden altered sensorium and unconsciousness of 4 hours duration. Imaging revealed an acute basilar artery occlusion.
He was immediately taken up for mechanical thrombectomy to restore cerebral circulation. During the procedure, a critical stenosis in the V4 segment of the vertebral artery was identified as the underlying cause. Gentle balloon angioplasty combined with thrombectomy achieved complete re-establishment of blood flow.
Timely intervention proved lifesaving.
Case 2
A 40-year-old young male presented with similar symptoms and was diagnosed with an acute basilar artery stroke. He underwent urgent mechanical thrombectomy, resulting in full restoration of circulation.
Basilar artery strokes demand rapid recognition, decisive action, and seamless teamwork.
🧠 Every minute of delay risks irreversible brainstem injury.
🧠 Timely endovascular intervention can dramatically change outcomes.
Proud of the coordinated stroke team effort that made these recoveries possible.

Case Highlight | Chronic Subdural Hematoma – Multimodality ManagementA 70-year-old male with significant cardiac comorbi...
12/02/2026

Case Highlight | Chronic Subdural Hematoma – Multimodality Management
A 70-year-old male with significant cardiac comorbidities — coronary angioplasty, left ventricular dysfunction (EF 39%), ICD for MMVT, diabetes mellitus, and hypertension — presented with 2 weeks of headache and dizziness, with a history of a trivial fall 3 weeks earlier.
CT brain revealed a chronic subdural hematoma with mass effect and midline shift.
Considering his high cardiac risk, he underwent burr hole evacuation under local anesthesia, with an uneventful recovery and discharge.
At 2-week follow-up, imaging showed residual / recurrent acute-on-chronic SDH. After detailed discussions with the family, we proceeded with Middle Meningeal Artery (MMA) embolization as a minimally invasive adjunct treatment.
✅ At 12 weeks post-embolization, follow-up CT scan showed complete resolution of the subdural hematoma.
This case highlights the evolving role of MMA embolization as a safe and effective option for managing recurrent or residual chronic subdural hematomas, particularly in high-risk surgical patients.

🩺 Neurointervention Cases of the Week Case 1:A 45-year-old male presented with acute severe headache due to aneurysmal s...
17/01/2026

🩺 Neurointervention Cases of the Week

Case 1:

A 45-year-old male presented with acute severe headache due to aneurysmal subarachnoid hemorrhage (SAH).
Imaging revealed an ACOM artery aneurysm.
➡️ He underwent uneventful simple coiling with an excellent result and was discharged neurologically intact.

Case 2:
A 40-year-old female presented with sudden severe headache and loss of consciousness, followed by complete recovery. She was referred from another hospital for definitive management.
Evaluation showed a bilobed MCA aneurysm.

➡️ She underwent uneventful simple coiling, achieving excellent angiographic and clinical outcome.

Timely diagnosis, appropriate endovascular strategy, and team-based care continue to make a meaningful difference in patient outcomes.

🙏 Grateful to the entire neurology, anesthesia, and nursing teams for their coordinated efforts.




🧠

A Turning Point in Idiopathic Intracranial Hypertension (IIH)A 38-year-old hypertensive female with chronic headaches fo...
14/01/2026

A Turning Point in Idiopathic Intracranial Hypertension (IIH)

A 38-year-old hypertensive female with chronic headaches for 5–6 years was diagnosed with Idiopathic Intracranial Hypertension (IIH). Despite prolonged medical management with multiple medications, she had no significant relief.
Recently, she developed worsening symptoms — tinnitus, nausea, blurred vision, and papilledema.

A detailed evaluation by our Neurology team revealed:
Opening CSF pressure >30 cm H₂O.

MRI findings consistent with IIH
Bilateral transverse sinus (TS) stenosis.

After thorough discussions with the patient and her family, we planned right-sided TS junction pressure monitoring, followed by stenting if a significant gradient was present.

🔹 Procedure highlights:
Pre-procedure pressure gradient: 21 mmHg
Post-stenting gradient: 2–3 mmHg
Successful right transverse sinus stenting performed

📈 Outcome:
Post-procedure day 2: Marked clinical improvement
Complete relief of tinnitus and headaches
Significant improvement in visual clarity.

We are hopeful to gradually taper and discontinue her medications as her recovery progresses.

✨ A gratifying outcome showcasing the role of venous sinus stenting in carefully selected IIH patients.




Two cases. One goal — safe aneurysm occlusion.We recently managed two patients with subarachnoid hemorrhage (SAH) using ...
14/01/2026

Two cases. One goal — safe aneurysm occlusion.

We recently managed two patients with subarachnoid hemorrhage (SAH) using endovascular techniques:

🔹 Case 1
A 40-year-old male presented with WFNS Grade I SAH.
Imaging revealed a left PICA aneurysm.
➡️ Successfully treated with uneventful simple coiling.

🔹 Case 2
An elderly patient presented with SAH due to rupture of a left anterior choroidal artery aneurysm.
➡️ Managed with uneventful endovascular coiling, achieving complete aneurysm occlusion with preservation of all critical branches.

Both patients tolerated the procedures well, reinforcing the importance of early diagnosis, meticulous technique, and timely endovascular intervention in aneurysmal SAH.






07/01/2026

Young Stroke | Rare Diagnosis | Definitive Cure 🧠✨
A 35-year-old male presented to a local hospital with features of a minor ischemic stroke. Routine stroke workup was unremarkable, and he was referred to our center for further evaluation.
Detailed assessment by our Neurology team identified a rare and under-recognized congenital cause of stroke — Carotid Web 🔍🩺.
The patient underwent uneventful carotid artery stenting, which definitively treats the pathology, with an excellent clinical outcome 🫀✅.
This case highlights the importance of looking beyond routine causes, especially in young stroke patients.

🧠 Carotid Revascularization | Case Highlights 🩸Case 1:A 58-year-old male with multiple transient ischemic attacks (TIAs)...
06/01/2026

🧠 Carotid Revascularization | Case Highlights 🩸
Case 1:
A 58-year-old male with multiple transient ischemic attacks (TIAs) and watershed infarcts was found to have severe carotid artery stenosis.
➡️ Successfully treated with carotid artery stenting under distal embolic protection.
Case 2:
A 52-year-old male with complete occlusion of the right internal carotid artery and severe stenosis of the left carotid artery, presenting with recurrent TIAs.
➡️ Managed with carotid artery stenting to restore cerebral perfusion.
🛠️ Materials Used:
• Ballast 6F Guide Sheath
• Emboshield NAV 6 Distal Protection Device
• Xact Carotid Stent (6 × 8 × 40 mm)
Both procedures were completed successfully with optimal angiographic results and neurological stability.
Early recognition and timely endovascular intervention can be stroke-saving. 🧠✨

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SPARSH HOSPITAL, , YELAHANKA BRANCH. , NEW AITPORT Road. KOGILU CROSS. NEHRUNAGARA
Bangalore
560064

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+918151999199

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