Specialties & Services

Neuroradiology

Our neuroradiologists use advanced imaging tools to see inside the brain, head, neck, and spine. These techniques allow for clearer, less invasive access to the diseases, disorders, and injuries causing neurological problems.

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Why choose us for neuroradiology?

BJC HealthCare works with WashU Medicine physicians, BJC Medical Group, and providers across the region to deliver extraordinary care. We believe in comprehensive, expert care for all our patients. You have access to an entire team of specialists who work together to provide safe, effective treatment. Our neuroradiologists and interventional neuroradiologists diagnose and treat a full range of conditions affecting the brain, head, neck, and spinal cord.

We offer:

Advanced technology: Our neuroradiologists have access to some of the most advanced imaging tools in the world. Your care may include MRI, positron emission tomography (PET), CT scans, angiography, ultrasound, or X-rays.
Interventional techniques: Thanks to interventional neuroradiology services, you have access to treatments that result in faster recoveries and better healing. These techniques allow us to offer very targeted treatments with minimal or no incisions.
State-of-the-art facilities: Our health system includes the most well-equipped and staffed facility in the St. Louis region for management of neurovascular disorders. Our system is home to two bi-plane digital angiographic units dedicated to neurovascular procedures.
Recognized expertise: The interventional neuroradiology service at the Barnes-Jewish & WashU Neuroscience Center is the largest in the region and one of the busiest in the country. Our specialists are recognized experts in the field.

What is neuroradiology?

Endovascular neurosurgery and interventional neuroradiology

You may be treated by a healthcare provider who focuses on the central nervous system if you have a problem that affects your brain or spinal cord. These healthcare providers can do procedures that are minimally invasive. This means the procedure can be done with a tiny cut (incision). That's often better than a larger incision that is needed for open surgery.

Endovascular neurosurgery is practiced by a neurosurgeon or neuroradiologist who is specialty trained in neurointerventional surgery. The word endovascular means inside a blood vessel. This type of surgery is also known as interventional neuroradiology. It is done with thin tubes (catheters) and small tools. These are put into the blood vessels. This is done instead of surgery with a large cut (incision). The surgeon often uses radiology images at the same time. These help the surgeon see the part of the body being treated.

Endovascular neurosurgery

Neurosurgery is a type of surgery that treats problems of the brain and nerves. Endovascular neurosurgery is a subspecialty within neurosurgery. These healthcare providers are trained in both neurosurgery and radiology. Then they do a neurosurgery residency at a hospital. After that, they do a fellowship program in endovascular neurosurgery. A neurosurgeon may be board certified in neurosurgery through the American Board of Neurological Surgery. There is no board-certified specialty for endovascular neurosurgery.

Interventional neuroradiology

Radiology is a specialty that helps diagnose and treat conditions with imaging methods. Interventional neuroradiology is a subspecialty of radiology.

These healthcare providers are trained in radiology. And they are trained in neurology or neurosurgery. Then they do a radiology residency at a hospital. After that, they do a fellowship program in interventional neuroradiology. A radiologist may be board certified in neuroradiology. This is done through the American Board of Radiology.

What kinds of procedures are done by these specialists?

The procedures include:

Thrombolytic therapy. This uses medicine to dissolve a clot in a blood vessel in the brain.
Blood clot retrieval. This uses a small catheter to remove a blood clot that is blocking the blood flow in a brain artery.
Endovascular coiling. This is done to treat a brain aneurysm. A brain aneurysm is a bulge in a weak spot in the wall of an artery in the brain that fills with blood. The bulge is at risk of a tear (rupture). This would cause bleeding on the brain. A surgeon puts a very thin metal coil inside the aneurysm to prevent this. It blocks blood flow into the bulging area. It may also be closed with a clip.
Minimally invasive spine surgery. This is done to treat spinal problems. These include fractures, tumors, compressed nerves, and other conditions that put pressure on the spinal cord.
Cerebral angiography. This is a radiology procedure. It looks at how blood is flowing in the brain.
Carotid artery angioplasty and stenting. The carotid arteries send blood and oxygen to the brain. This procedure uses a small balloon to open a carotid artery that has become too narrow. A tiny mesh tube called a stent is then put in place. It keeps the artery open.

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Our highly trained team of specialists offers advanced treatments as well as compassionate, personalized care.

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Types of neuroradiology treatments

We work closely with neurology, neurosurgery, and vascular surgery to evaluate, diagnose, and treat neurological disorders. Our team meets weekly to discuss the most effective treatment approaches for our patients.

Common endovascular techniques and treatments include:

Aneurysm treatment

We may fill an aneurysm with soft platinum coils to block blood flow to the aneurysm. Sometimes we also use stents or balloons to help keep the coils in the right place.

Angiography

We place a catheter in an artery in your groin, then direct the catheter to your blood vessels. Once the catheter is in position, we inject special dye to highlight blood vessels on an X-ray.

Arteriovenous malformation (AVM) catheterization

We treat AVMs by injecting different materials into the blood vessels. This blocks blood supply to the AVM, causing it to shrink.

Carotid-cavernous fistula (CCF) treatment

Endovascular embolization is the most common treatment for a CCF. We insert a coil into the fistula to block blood flow between the artery and vein.

Arterial stenosis treatment

We open narrowed arteries by inserting balloons inside the affected blood vessels. Sometimes we place a small metal tube called a stent to help keep the artery open.

Stroke treatment

We may use catheter techniques to deliver clot-busting drugs directly to a blood clot. Or we insert special devices through the catheter to remove clots.

Vascular tumor embolization

Embolization blocks blood flow to a tumor. We may perform embolization before surgery to lessen blood loss, making surgery safer and faster.

Vessel dilation

We treat vasospasm by opening arteries with specific drugs and using balloons to widen the blood vessels.

Spine treatment

We use interventional techniques to perform a variety of procedures on the spine, including biopsies, nerve root injections for pain relief, and diagnostic discograms (a test for painful spinal discs).