brainscan

Brain Aneurysm and Arteriovenous Malformations Program

The Brain Aneurysm and Arteriovenous Malformations Program at the Massachusetts General Hospital Fireman Vascular Center offers sophisticated diagnosis and innovative treatments for patients with intracranial (brain) aneurysms and rare conditions such as arteriovenous malformations (AVMs) of both the brain and spinal cord.
Request an appointment Request a second opinion

Call to request an appointment or to refer a patient 877-644-8346

About this Program

A Multidisciplinary Approach to Neurovascular Care

The Brain Aneurysm and Arteriovenous Malformations Program at the Massachusetts General Hospital Fireman Vascular Center offers sophisticated diagnosis and treatments for patients with intracranial (brain) aneurysms, arteriovenous malformations (AVMs) and other rare vascular conditions of the brain and spinal cord, such as moyamoya, cavernous malformations, dural arteriovenous fistulas, spinal cord AVMs and arteriovenous fistulas, and intracranial vascular occlusive disease.

The Mass General Fireman Vascular Center is one of the only vascular centers in the country with specialists in every area of vascular disease. Our program comprises leading experts within the field of vascular medicine, bringing together a team of clinicians from multiple disciplines to provide care from many perspectives, including:

  • Neurosurgery
  • Neurointerventional radiology
  • stroke neurology
  • Diagnostic neuroradiology

Our patients receive a comprehensive, multidisciplinary evaluation and a treatment plan personalized to their individual needs. Additionally, we collaborate with referring physicians each step of the way to ensure that the patient’s entire care team is in communication around his or her treatment plan.

Mass General is also home to one of the nation’s largest intensive care units dedicated to treating patients with acute brain condition. The Neurosciences Intensive Care Unit (Neuro ICU) comprises stroke and critical care specialists offer leading vascular management using state-of-the-art technology and other resources.

Leading Treatment Options for Brain Aneurysms

A brain aneurysm (also known as a cerebral aneurysm or intracranial aneurysm) is a bulging area in the wall of the artery that delivers blood to the brain. Vessel weakness is usually present at birth and the bulging develops slowly over time.

While most brain aneurysms cause no symptoms and therefore go unnoticed, small percentages are at risk for leaking or rupturing, causing bleeding into the brain (subarachnoid hemorrhage or hemorrhagic stroke).

Upon diagnosis, our expert clinicians will evaluate each individual case and provide recommendations for treatment or monitoring. It is important to consider all options. Not all aneurysms require treatment and for aneurysms that require treatment, multiple options need to be considered. Patients who do not require treatment will continue to be closely followed by their team of clinicians in the Brain Aneurysm and AVM Program.

In the Brain Aneurysm and AVM Program, our main goal is to evaluate the patient and, for aneurysms that require treatment, design an individualized treatment plan that closes the aneurysm to prevent rupture. Treatment is determined according to the patient’s age, medical condition, and the size, shape and location of the brain aneurysm. Treatment options available include minimally invasive endovascular techniques and surgical techniques.

Minimally invasive endovascular techniques:

  • Coil Embolization: During this minimally invasive endovascular procedure, a catheter (thin, flexible tube) is used to insert a metal coil into the aneurysm. This blocks blood flow from entering into the aneurysm, preventing future rupture. Micro-stents (metal-mesh tubes) can be used with the coils to assist in keeping the coils within the aneurysm

  • Flow Diversion: During this minimally invasive endovascular procedure, a catheter is used to insert a mesh stent across the base of an aneurysm to divert blood flow away from the aneurysm, preventing future risk of rupture. Newer flow diversion techniques also allow placement of devices within the aneurysm to divert blood flow away from the aneurysm

Surgical techniques:

  • Microsurgical Clip Occlusion: This surgical procedure involves identifying the aneurysm between the folds of the brain through micro-dissection, a technique that uses a surgical microscope to dissect the aneurysm. A titanium clip is then placed across the “neck” (base) of the aneurysm, closing it off. This treatment approach may be recommended if the aneurysm is not suited for endovascular techniques because of its shape and relationship to the normal vessels. Although microsurgical clip occlusion is not “minimally invasive,” it has lower recurrence rates compared with embolization techniques

  • Microsurgical bypass: This surgical procedure involves bypassing blood flow around a large aneurysm by using microsurgical techniques to divert blood flow

Specialists Dedicated to Neurovascular Imaging

To accurately diagnose brain aneurysms, AVMs, moyamoya and other vascular malformations, our team includes neurovascular radiologists who are specially trained to detect abnormalities in the vascular system and whose practice focuses specifically on neurovascular disease. These intracranial imaging specialists are board certified in general radiology and fellowship trained with additional specialization in neurovascular procedures. Additionally, our doctors have expertise in diagnosing and treating conditions, such as fibromuscular dysplasia, that place patients at higher risk for developing aneurysms.

At the Fireman Vascular Center, we also offer computed tomography angiography (CTA), a technique that produces detailed 3D images of the blood vessels. CTA is considered less invasive, and our neurovascular specialists are skilled in interpreting its results. Depending on the patient, we may use other diagnostic techniques such as:

  • Ultrasound
  • CT scan
  • Magnetic resonance imaging (MRI)
    Magnetic resonance angiography (MRA), a type of MRI that provides images of blood vessels
  • Venograms, a type of X-ray of the veins performed after a special dye is injected into the veins
  • Arteriograms, a type of imaging test to view the inside of the arteries

Many of these tests are also available at our convenient Waltham location

Convenient Waltham Location

Specialists in the FMD program practice at Mass General and at our convenient location in Waltham. Mass General West offers outpatient services for people with FMD, including imaging, consultation and coordinated care with multiple specialists. Free garage parking is also available.

Learn more about our Waltham location

Clinical Trials and Research

In addition to seeing patients, specialists within our center also conduct research, and participate in major clinical studies evaluating new technologies and devices to treat brain aneurysms, AVMs and other vascular disorders of the brain and spinal cord. This allows us to bring our patients promising new treatments as quickly as possible.

Patients interested in participating in a trial can browse online for open clinical trials or contact a member of their care team to learn more.

What to Expect at Your First Appointment

During your first consultation, your care team will conduct a physical examination and review your medical history.

If you are a new patient to Mass General, we ask that you bring a list of the medications, vitamins and herbal supplements that you take, along with information on dosages. Additionally, please bring any medical records, CDs of images, consultation notes, and notes on previous treatments and their effectiveness. We use this information at the time of your first visit to get a complete picture of you and your overall condition in order to develop an appropriate treatment plan.

We may recommend additional testing, if needed, and will help coordinate any scheduling. Our team will collaborate with your referring physician, and ensure that he or she is aware of any test results and next steps in your treatment.

One Call Coordinates Care

Our dedicated nurse coordinator is available Monday through Friday from 8:30 am to 5:00 pm to take relevant information about your condition and symptoms, and to make a timely appointment with the most appropriate specialist. Call 877-644-8346 or request an appointment online

The Mass General Difference

Mass General is consistently ranked among the best hospitals in the country by U.S. News & World Report. Our ranking is based on our quality of care, patient safety and reputation in 16 different specialties. Our commitment to excellence means that we work to ensure that you can receive the best care at all points during your visit.

Our specialists have a long tradition of excellence in clinical care, and are national leaders in the diagnosis and treatment of brain aneurysms and AVMs. Our physicians are at the forefront of new research and serve on national and international professional societies.

Conditions & Diseases

Mass General is dedicated to ensuring that people understand their health care choices and have the necessary information to make decisions affecting their health and well being. The related support and wellness information listed below can play a role in treatment options.

  • Cerebral Aneurysm

    A cerebral aneurysm (also called an intracranial aneurysm or brain aneurysm) is a bulging, weakened area in the wall of an artery in the brain, resulting in an abnormal widening or ballooning. Because there is a weakened spot in the artery wall, there is a risk for rupture (bursting) of the aneurysm.

Patient Education

Mass General is dedicated to ensuring that people understand their health care choices and have the necessary information to make decisions affecting their health and well being. The related support and wellness information listed below can play a role in treatment options.

  • Designing an Exercise Program

    When you exercise, you'll breathe faster and more deeply. This maximizes the amount of oxygen in your blood.

  • Healthy Eating

    Many vascular conditions can be improved by changing certain lifestyle factors. Maintaining a healthy weight is one of many factors. If you are trying to make heart-healthy changes to your diet, it is helpful to know some basics about nutrition, starting with the components of food.

  • Determining Your Body Mass Index

    A good indicator of how much fat you carry is the Body Mass Index (BMI). Although it is not a perfect measure, it gives a fairly accurate assessment of how much of your body is composed of fat.

News

Video

  • Massachusetts General Hospital Fireman Vascular Center research milestones slideshow

    Access to new treatments

    Fireman Vascular Center physicians and scientists participate in international research and lead more than 70 clinical trials that evaluate current therapies and investigate new devices to treat vascular disease. These research efforts have led to a number of groundbreaking firsts, bringing innovative new treatments to the patient’s bedside.

Contact

Contact Us

Vascular Center

55 Fruit Street Boston, MA 02114
  • Phone: 877-644-8346

Hours

  • 9:00 am to 5:00 pm

Vascular Center at Waltham52 Second Avenue, Suite 2100
Waltham, MA 02451
Phone: 
877-644-8346
Hours:
8:00 am to 5:00 pm
Learn about our convenient Waltham location

Request an appointment Request a second opinion

Call to request an appointment or to refer a patient 877-644-8346

Back to Top