When something goes wrong with the blood vessels in the brain, every minute counts. Interventional neurology allows doctors to treat these problems from inside the blood vessels, using thin tubes called catheters and real-time X-ray imaging, often without opening the skull.
At CMRI Hospital, Kolkata, our interventional neurologists work with neurologists, neurosurgeons, neuroradiologists, anaesthetists and critical care specialists to give patients fast, safe and carefully planned care for stroke and other neurovascular disorders.
Interventional neurology, also called neurointerventional or endovascular neurology, is a specialty that diagnoses and treats diseases of the brain’s blood vessels using minimally invasive, image-guided techniques. You may also hear the related term interventional neuroradiology, which covers much of the same work.
An interventional neurologist is a neurologist who has completed additional, specialised training in these procedures. The care is always team-based, so your treatment plan is shaped by several experts, not one.
Interventional neurology is used for conditions that affect the brain’s blood supply, collectively called neurovascular disorders. These include:
Not every patient needs an interventional procedure. Your doctor will recommend the best option, which may be medicines, endovascular treatment, surgery, radiosurgery, or a combination.
A dye (contrast) is injected through a catheter while X-ray images capture detailed pictures of the brain’s blood vessels. It helps diagnose aneurysms, AVMs, blockages and narrowing, and is often the first step before treatment.
In this emergency procedure, a catheter is guided to the blocked brain artery and the clot is removed using a small mesh device (stent retriever) or a suction catheter. It is used for strokes caused by a blockage in a large brain artery and can greatly improve the chance of recovery when done quickly. It is sometimes combined with clot-dissolving medicine given through a drip.
Options include:
Some aneurysms are better treated with open surgical clipping, so the choice depends on size, location and shape.
Embolisation uses a special medical glue or other material, delivered through a catheter, to block the abnormal vessels. It is often combined with surgery or radiosurgery for the best result.
A small stent is placed to open a narrowed neck artery and restore blood flow, usually with a tiny protective filter to catch debris. For some patients, a surgical procedure called carotid endarterectomy may be a better choice.
A tiny balloon or stent opens a narrowed artery inside the skull in selected patients, usually when medicines alone have not prevented strokes.
You may be given local anaesthesia with sedation, or general anaesthesia for longer or more complex procedures. The brain itself does not feel pain. You may feel pressure or brief discomfort at the puncture site.
Generally no. You will receive anaesthesia or sedation, and the brain has no pain sensation. Some patients feel mild soreness or bruising at the puncture site afterward, which usually settles in a few days.
These commonly include a CT or MRI of the brain, CT or MR angiography, blood tests (including kidney function and clotting tests), and an ECG. Your doctor will decide which are needed for your condition.
In some cases, yes. If a stroke is caused by a severely narrowed carotid or brain artery, stenting or angioplasty may lower the risk of another one. Prevention also relies on medicines, blood pressure, sugar and cholesterol control, quitting tobacco, and a healthy lifestyle.
It is mainly for patients with a stroke caused by a blockage in a large brain artery, confirmed on scans. It is most effective when done early, usually within about 6 hours of symptom onset, and in selected patients it may help up to 24 hours when advanced imaging shows salvageable brain tissue. Your stroke team decides eligibility quickly after scans.
Often, yes. Age by itself is not a barrier. Doctors look at overall health, daily function before the illness, and the condition being treated. Many older adults benefit, particularly from stroke treatment.
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