Cerebrovascular Issues

Itay Melamed, MD -  - Neurosurgeon

Advanced Brain & Spine

Itay Melamed, MD

Neurosurgeon located in Centennial, CO & Wheat Ridge, CO

Cerebrovascular Issues Specialist
Cerebrovascular issues include any condition or problem that affects the blood supply to your brain. A wide variety of problems can lead cerebrovascular issues, ranging from a stroke to a blood vessel malformation. At Advanced Brain & Spine, board-certified neurosurgeon Dr. Itay Melamed specializes in the treatment of all cerebrovascular issues. If you’re in the Denver area and you’d like to learn more, call or book your appointment online at one of the practice’s two convenient locations in Centennial or Wheat Ridge, Colorado.

Cerebrovascular Issues Q&A

by Itay Melamed, MD

What is cerebrovascular disease?

Your brain controls everything from the beating of your heart to your ability to walk, talk, and make sense of the world around you. Cerebrovascular disease, or any of the problems or conditions that affect the blood supply of your brain, can deprive your brain cells of oxygen.

Although a major event like a stroke can have potentially devastating consequences, less severe conditions that reduce cerebral blood flow can also affect normal brain function. Common cerebrovascular problems include:

  • Stroke
  • Transient ischemic attack (TIA)
  • Arteriovenous malformations (AVMs)
  • Dural fistulas
  • Aneurysms
  • Cavernous hemangiomas
  • Subarachnoid hemorrhage
  • Vascular dementia


Because these brain abnormalities are as different from one another as apples and oranges, they each require a different treatment approach.

What are arteriovenous malformations?

An arteriovenous malformation (AVM) is an abnormal blood vessel in the brain. AVMs are generally a congenital disorder, meaning most patients who have them were born with them.

AVMs are often discovered by accident, either through a CT scan or an MRI, that’s being done for an unrelated issue. AMVs can cause problems, however, including seizures or an intracranial hemorrhage; although bleeding from an AVM isn’t usually as bad as bleeding caused by an aneurysm, AMV-related hemorrhages can still cause serious problems.

What is a dural fistula?

A dural fistula is an abnormal connection of blood vessels in the membranes that surround the brain or spinal cord, including the dura mater, arachnoid, or pia mater. While it’s not always clear what causes a dural fistula, they often form following a large vein clot. Any symptoms are usually the result of increased pressure within the veins.

Dural fistulas are similar to AVMs, in that they both involve a tangle of blood vessels or an abnormal connection between the arteries and the veins.

What are the available treatment options?

Although there are a variety of available treatment options for cerebrovascular disorders, most patients begin by choosing whether to pursue active treatment or engage in watchful waiting.

An AVM, for example, may be observed through ongoing imaging, or treated through intracranial embolization. The decision whether to observe or treat an AVM is a difficult one, and while there’s no right or wrong choice, each choice comes with its own set of potential risks.

Patients who opt for continued observation may monitor their cerebrovascular condition through regular MRI scans, CT scans, or traditional angiograms.

Depending on the specific problem, treatment options may include endovascular methods as well as open surgery or radiosurgery. Dr. Melamed specializes in all forms of cerebrovascular treatment; call the nearest office or book your appointment online today.

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