Pacific Stroke & Neurovascular Center

• Thrombolytic Therapy (tPA)
  Clot-dissolving medication is given intravenously to eligible patients with acute ischemic stroke. It is most effective when administered within the first few hours of symptom onset.
• Mechanical Thrombectomy
  This catheter-based procedure to physically remove a large clot from a blocked brain artery is often used for severe strokes caused by large vessel occlusion.
• Hemorrhagic Stroke Management
  This involves comprehensive care including neurocritical monitoring, surgical evacuation of bleeding, and treatment of underlying causes such as ruptured aneurysms or arteriovenous malformation (AVMs).
• Medical Management of Transient Ischemic Attack (TIA)
  With a focus on identifying stroke risk factors and preventing future strokes through, recommendations include medications (e.g., antiplatelets, anticoagulants), lifestyle changes, and vascular risk control.

• Endovascular Treatments
  Experts perform minimally invasive endovascular procedures where fine catheters are inserted through blood vessels, typically in the leg, to reach and treat abnormal blood flow in conditions such as brain aneurysms, AVMs, dural fistulas, or cavernomas. Microvascular neurosurgery allows our surgeons to safely deliver coils, glue, or other materials and access even the most difficult regions of the brain using the smallest possible incisions.
• Surgical Clipping or Resection
  A traditional neurosurgical technique to clip aneurysms or remove vascular malformations like AVMs and cavernomas when endovascular therapy is not appropriate.
• Stereotactic Radiosurgery (e.g., Gamma Knife)
  A non-invasive, targeted radiation treatment that gradually closes off small AVMs or cavernomas, particularly those located deep within the brain.
• Carotid Endarterectomy
  A surgical procedure to remove plaque buildup from the carotid artery to restore blood flow and reduce the risk of stroke in patients with significant narrowing.
• Carotid Artery Stenting
  A catheter-based alternative to endarterectomy, where a stent is placed to widen a narrowed carotid artery and maintain healthy cerebral circulation.
• Revascularization Surgery for Moyamoya Disease
  Microsurgical bypass techniques (extracranial-to-intracranial bypasses) are used to reroute blood flow around narrowed or blocked arteries, improving oxygen supply to the brain and preventing future strokes.

Intracranial atherosclerotic disease (ICAD) occurs when plaque builds up inside the arteries that supply blood to the brain, causing them to narrow. It is one of the most common underlying causes of stroke and transient ischemic attack (TIA), particularly in people with hypertension, diabetes, or high cholesterol. The Pacific Stroke and Neurovascular Center offers both medical management and endovascular treatment for patients with ICAD at high risk for stroke.

Subclavian steal syndrome develops when a blocked or narrowed subclavian artery causes blood to reverse flow through the vertebral artery, diverting circulation away from the brain to supply the arm. This can cause dizziness, balance problems, or posterior circulation symptoms, especially when the affected arm is active. Treatment ranges from observation and medication to angioplasty, stenting, or surgical bypass depending on severity.

Cerebral vasospasm is an abnormal narrowing of blood vessels in the brain that most often occurs in the days following a subarachnoid hemorrhage. It can restrict blood flow and lead to delayed stroke or worsening neurological deficits, making close monitoring a critical part of recovery. Our experts use transcranial Doppler imaging, nimodipine therapy, and endovascular intervention to detect and manage vasospasm.

Venous and lymphatic malformations are congenital clusters of abnormal blood or lymphatic vessels that can develop in the head, neck, or brain. Unlike arteriovenous malformations, they are low-pressure lesions, but they can grow over time, cause pain, or compress nearby structures. Treatment is individualized and may include sclerotherapy, laser therapy, surgical resection, or observation by a multidisciplinary neurovascular team.

The venous sinuses are large channels in the brain that drain blood and cerebrospinal fluid. When these channels narrow, pressure can build inside the skull, causing persistent headaches, vision changes, and in some cases a whooshing or pulsing sound in the ears. We evaluate venous sinus stenosis with advanced imaging and offer both medical management and minimally invasive interventional options tailored to each patient’s anatomy and symptoms.

The vertebral and basilar arteries supply blood to the back of the brain, which controls balance, coordination, vision, and vital functions. When blood flow through these vessels is reduced, patients may experience sudden dizziness, double vision, difficulty walking, or brief episodes of weakness, sometimes called “drop attacks.” Our specialists evaluate vertebrobasilar insufficiency using detailed vascular imaging and develop personalized treatment plans to reduce stroke risk and protect neurological function.

Our Stroke Support Groups can help you on your road to recovery. Stroke is a preventable disease and studies indicate that 80% of strokes can be prevented. Identifying the risk factors that contribute to stroke can help reduce the likelihood of having a stroke.

Details regarding insurance coverage, and billing information are available at Providence.org.