Understanding Cerebrovascular Disorders and How Minimally Invasive Neurosurgery Can Help

Welcome to Brain Blog — an insightful and easy-to-understand resource for those impacted by cerebrovascular, endovascular, skull base, and spinal disorders.

I’m Dr. Ravi H. Gandhi, a board-certified neurosurgeon at Orlando Neurosurgery. I am fellowship-trained in Cerebrovascular, Endovascular, and Skull Base Neurosurgery, and my goal is always to find the least invasive way to treat complex conditions of the brain and spine — often avoiding open surgery altogether.

I believe in treating every patient as if they were a member of my own family. I also encourage caregivers to be part of the treatment and recovery process, because support at home is just as important as the care we provide in the hospital. Through my practice at Orlando Neurosurgery and as part of the elite team at the AdventHealth Neuroscience Institute, I’ve had the privilege of helping patients across Central Florida overcome some of the most challenging neurological conditions.

In this article, I want to share an overview of four common cerebrovascular disorders — stroke, aneurysms, arteriovenous malformations (AVMs), and carotid/vertebral artery stenosis — and explain how modern, minimally invasive neurosurgery is changing the outlook for patients and families facing these diagnoses.

What Are Cerebrovascular Disorders?

Cerebrovascular disorders are conditions that affect the blood vessels of the brain and spine. Just as your heart depends on a healthy blood supply, so does your brain. When a vessel becomes blocked, weak, or abnormally formed, it can have serious and sometimes life-threatening consequences.

What makes these disorders especially frightening is how suddenly they can appear. A stroke or aneurysm rupture can happen without warning. But thanks to major advances in technology, many of these conditions can now be treated using endovascular and minimally invasive neurosurgery techniques.

Instead of a large incision, I can often use a tiny catheter — guided through the arteries from the wrist or groin — to treat the problem directly at its source. This means less pain, quicker recovery, and better outcomes for my patients.

Stroke: Every Minute Counts

A stroke happens when blood flow to part of the brain is interrupted — either by a blood clot (ischemic stroke) or bleeding (hemorrhagic stroke). Stroke is one of the leading causes of disability and death in the United States.

When I talk to patients and their families about stroke, I always emphasize the acronym FAST:

• Face: Is one side drooping?

• Arm: Is there weakness or numbness in one arm?

• Speech: Is speech slurred or strange?

• Time: Call 911 immediately.

Every second matters during a stroke. As part of the AdventHealth Neuroscience Institute’s stroke team, I work closely with emergency physicians and neurologists to deliver life-saving care. Using mechanical thrombectomy (clot retrieval) and stenting, to restore blood flow in real time. These procedures are minimally invasive and can make the difference between lifelong disability and recovery.

Aneurysms: Silent but Serious

A brain aneurysm is a weak spot in a blood vessel wall that bulges outward. Many aneurysms don’t cause any symptoms until they rupture — and when that happens, it can be life-threatening.

Whenever I diagnose an unruptured aneurysm, my goal is to prevent rupture before it occurs. Using endovascular techniques, I can insert tiny coils or flow-diverting stents inside the aneurysm to reinforce the vessel wall. These procedures are performed without open brain surgery — just through a small catheter.

If a patient comes to me with a ruptured aneurysm, we act quickly. The priority is to stop the bleeding, reduce the risk of further rupture, and stabilize the patient. Even in emergencies, minimally invasive procedures give us powerful tools to save lives while minimizing recovery time.

Arteriovenous Malformations (AVMs): Untangling the Risks

An AVM is an abnormal tangle of arteries and veins in the brain or spine. Because these vessels bypass the body’s normal blood flow control, they can rupture and cause dangerous bleeding. Patients with AVMs may experience seizures, headaches, or neurological symptoms — though sometimes AVMs are found by accident on imaging.

When treating an AVM, I carefully consider its size, location, and the risks it poses. One option is endovascular embolization, where I use a catheter to deliver materials that close off the abnormal vessels. In some cases, treatment may also involve radiosurgery or microsurgery.

My goal is always to design a treatment plan that reduces risk while protecting brain function. By tailoring each plan to the individual patient, we can often achieve excellent outcomes.

Carotid and Vertebral Artery Stenosis: Preventing Stroke Before It Happens

While conditions like stroke and aneurysm can appear suddenly, some risks develop slowly over time. One example is carotid or vertebral artery stenosis, a narrowing of the arteries in the neck that supply the brain. This narrowing is often caused by plaque buildup, and many patients don’t know they have it until a stroke occurs.

That’s why screening and early detection are critical. When I diagnose stenosis, I use angioplasty and stenting to restore healthy blood flow. These procedures open the narrowed artery, lower the risk of stroke, and give patients peace of mind knowing their future risk has been reduced.

Why Minimally Invasive Matters

One of the greatest changes in my field has been the evolution of minimally invasive neurosurgery. Instead of large incisions and long recoveries, many patients today can be treated with tiny catheters and advanced imaging tools.

Here are just a few of the benefits:

• No open incision in the head for most procedures

• Less trauma to brain tissue

• Shorter hospital stays

• Faster recovery

• Smaller scars — or none at all

For my patients, this means they can get back to their families and their lives sooner. It also means less fear surrounding the idea of “brain surgery.”

My Approach to Care

While I am proud of the technology we use, what matters most to me is how I treat my patients. I believe in spending time to explain conditions in plain language, answering questions honestly, and involving loved ones in every step of the process.

Every patient deserves to feel heard and supported. That’s why my guiding principle is to treat patients as if they were members of my own family. I want them to know they’re not just receiving treatment — they’re receiving compassion, understanding, and partnership.

At Orlando Neurosurgery, I see patients across seven Central Florida locations, making advanced neurosurgical care accessible throughout our community. In my role as a Medical Director at AdventHealth Neuroscience Institute, I also collaborate with an outstanding multidisciplinary team, which ensures my patients benefit from the expertise of neurologists, radiologists, rehabilitation specialists, and more.

Cerebrovascular disorders like stroke, aneurysms, AVMs, and artery stenosis can sound overwhelming. But the message I want to leave you with is one of hope. Thanks to modern, minimally invasive neurosurgery, we can treat these conditions more safely and effectively than ever before. If you or a loved one has been diagnosed with a cerebrovascular disorder, please know you are not alone. My team and I are here to walk with you, explain your options, and provide the best care possible.

The information provided in this blog is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Every patient’s condition is unique, and what is described here may not apply to your specific situation. Please do not disregard professional medical advice or delay seeking care because of something you have read here. Always consult your physician or qualified healthcare provider with any questions you may have regarding a medical condition.