Surgery after stroke can be a life-saving procedure.
There are 5 main types of surgery after stroke, and this article will discuss all of them. Some are used for stroke treatment and others are used for prevention.
We’ll start with the types of surgery that are used to treat stroke and then move onto preventive surgeries after.
Saving a Life with Surgery After Stroke
A stroke is caused when the blood flow to the brain is compromised by either a clogged or burst artery.
The lack of oxygen-rich blood to the brain causes brain damage, and fast treatment is essential for minimizing this damage.
There are 3 types of surgery that are used to treat stroke and restore blood flow to the brain.
This surgery is used to treat swelling in the brain after both ischemic or hemorrhagic stroke.
When there’s too much swelling in the brain after stroke, it creates unhealthy pressure on the brain (intracranial pressure) that can lead to further brain damage and even death.
Hemicraniectomy is an aggressive procedure where a section of the skull – sometimes half of the skull or more – is removed to allow the brain to swell beyond the limits of the skull and alleviate the excess pressure.
Once the swelling goes down, the skull can be sutured back into place.
Hemicraniectomy is a controversial procedure. On one hand, it can save a life, but on the other hand, it can unfortunately leave patients severely disabled with low quality of life.
2. Mechanical Embolectomy
This surgery is used to treat ischemic stroke, which is caused by a blood clot in the brain.
During mechanical embolectomy, the blood clot in the brain is removed using a stent, which is a tiny wire mesh tube that helps prop an artery open.
The stent is inserted into an artery through a catheter starting in the leg, making it a much less invasive than brain surgery.
When the catheter is removed, the stent and the clot are removed along with it.
Surgical Management of Stroke
Other types of surgery after stroke are used for stroke prevention instead of treatment.
These surgeries are performed for individuals at high risk of stroke, like those with brain aneurysms and atherosclerosis, a stroke risk factor.
3. Aneurysm Clipping
An aneurysm is a weak, bulging area in the wall of an artery.
When an aneurysm in the brain ruptures, it causes a hemorrhagic stroke (bleeding in the brain). An aneurysm is more likely to rupture if you have the stroke risk factor of high blood pressure.
An aneurysm clipping is one of two ways to treat an aneruysm.
During an aneurysm clipping, a tiny metal clip is used to isolate the aneurysm from your normal blood flow to prevent it from rupturing.
The clip is inserted during craniotomy, a type of surgery which involves opening the skull and working directly with the brain. This makes it a highly invasive treatment.
4. Aneurysm Coiling
Aneurysm coil embolization is another way to treat an aneurysm.
During coil embolization, tiny metal coils are inserted into the aneurysm bulge to isolate it from the normal blood flow. Eventually, a clot forms and reduces the risk of the aneurysm rupturing.
Surgery to perform a coil embolization involves entering the bloodstream through a catheter inserted in the upper leg, making it a less invasive procedure.
Aneurysm clippings and coiling are used to both treat and prevent hemorrhagic stroke from happening.
5. Carotid Surgery
During carotid endarectomy, a surgeon creates an incision in the neck and goes directly into the carotid artery to remove excess plaque.
While this greatly reduces your risk of stroke, there is a 2-3% risk of having a stroke during this procedure, and that risk increases to 3-5% if you have already experienced a stroke.
Carotid angioplasty and stenting is a less invasive way to remove plaque buildup in the carotid arteries.
Using a catheter, a balloon is inserted inside the carotid artery and inflated to open up the artery. A stent is then placed in the artery to prop open the artery walls and facilitate healthier blood flow.
Surgery for Stroke Management and Treatment
Some surgeries are used to help remove plaque from important arteries to treat and prevent ischemic stroke. Other surgeries are used to stop or prevent brain bleeding (hemorrhagic stroke).
Each type of surgery comes with its own risks and rewards, and it’s best to discuss your unique circumstances with your doctor or medical team.
However, because stroke is a medical emergency, some decisions are made in high pressure situations where there’s no time to discuss the pros and cons.
When stroke happens, you often just have to trust that your medical team will make the best possible decision for you or your loved one.