Stroke

Surgery

When surgery is being considered after a stroke, your age, prior overall health, and current condition are major factors in the decision. Surgery is not recommended as part of the initial or emergency treatment for ischemic stroke .

Surgery for ischemic stroke

Carotid endarterectomy. Carotid endarterectomy is surgery to remove plaque buildup in the carotid arteries in people with moderate to severe narrowing of the carotid arteries. This surgery can help prevent additional strokes. For more information, see:

Should I have carotid endarterectomy?

If a stroke has occurred because of a narrowed carotid artery, a carotid endarterectomy may help lower the risk of a future stroke.

You are most likely to benefit from surgery if you have had a TIA or mild stroke in the past 6 months and have 70% or greater narrowing in one of your carotid arteries. Carotid endarterectomy may be appropriate if your carotid arteries are moderately or severely blocked (50% to 69% narrowing) and you have had one or more TIAs or mild strokes.¹³ Talk to your doctor about whether a carotid endarterectomy is right for you.

Carotid endarterectomies are most successful when they are performed by a surgeon who is experienced in the procedure. Ask your doctor about his or her rate of complications.

Surgery for hemorrhagic stroke

Surgeries for hemorrhagic stroke include:

• Surgery to drain or remove blood in or around the brain that was caused by a bleeding blood vessel (hemorrhagic stroke).
• A procedure (endovascular coil embolization) to repair a brain aneurysm that is the cause of a hemorrhagic stroke. A small coil is inserted into the aneurysm to block it off. Whether this surgery can be done depends on the location of the aneurysm, its size, and whether you are healthy enough to withstand the procedure.
• Surgery to remove or block off abnormally formed blood vessels (arteriovenous malformations) that have caused bleeding in the brain. An arteriovenous malformation is a congenital disorder, which means it was present at birth. An arteriovenous malformation causes an abnormal web of blood vessels and veins in the brain, brain stem, or spinal cord. The vessel walls of an arteriovenous malformation may become weak and leak or rupture.

People with a brain aneurysm need evaluation of all their symptoms to determine whether and when surgery is needed. Endovascular coil embolization is the preferred treatment for people with a brain aneurysm. It is also used for those who are at high risk for complications from a surgical repair of the aneurysm.¹⁴ In cases where endovascular coil embolization is not possible, aneurysm clipping with craniotomy is done.

Go to previous section	Go to top of page	Go to next section
Author:	Monica Rhodes	Last Updated: January 8, 2009
Medical Review:	Anne C. Poinier, MD - Internal Medicine Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation
© 1995-2009 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.