What is Vascular Neurology?

Vascular Neurologists are Also Called 'Stroke Doctors'

Vascular Neurologist at Work. John Foxx/Getty Images

Vascular neurology, in layman's terms, is the treatment of strokes. Stroke is a disease that affects the arteries leading to and within the brain. A stroke occurs when a blood vessel carrying oxygen to the brain is either blocked by a clot or bursts. Part of the brain cannot get the blood (and oxygen) it needs, so it and brain cells die.

Types of Stroke

There are two types of strokes: hemorrhagic or ischemic.

During an ischemic stroke, a blood vessel supplying blood to the brain becomes blocked. During a hemorrhagic stroke, a weakened blood vessel ruptures and spills blood into brain tissue. There are two other types of weakened blood vessels that also cause hemorrhagic stroke: aneurysms (swelling of the vessel that breaks) and arteriovenous malformations (AVMs). Treatment differs depending on the type of stroke.

Just a few years ago, there was little that doctors could do to treat strokes. The lack of diagnostic techniques and effective treatments at the time made it acceptable for general neurologists, and even emergency room physicians, to diagnose and treat strokes. However, over the past few decades, neurologists and other physicians have developed multiple new and effective approaches to diagnose and treat strokes.

Ischemic Stroke Treatment

There is only only FDA-approved treatment for ischemic strokes: tissue plasminogen activator (tPA) which is given intravenously (in the arm).

tPA dissolves the clot and improves blood flow to the brain. 

Another treatment option is an endovascular procedure called mechanical thrombectomy which attempts to remove a large blood clot by sending a wired-caged device (called a stent retriever), to the site of the blocked blood vessel in the brain.

Hemorrhagic Stroke Treatment

Endovascular procedures may be used to treat certain hemorrhagic strokes similar to the way the procedure is used for treating an ischemic stroke. During these procedures, a catheter is inserted through a major artery in the leg or arm, then guided to the aneurysm; it then places a coil to prevent rupture.

Surgery can also help stop the bleeding. If the bleed is caused by a ruptured aneurysm, a metal clip may be placed surgically at the base of the aneurysm to secure it.

Vascular Neurologsts, aka 'Stroke Doctors'

To become proficient in these approaches, physicians must acquire a great deal of experience and training that is not usually provided to them during their general neurology training. The field of vascular neurology was born to address this gap in education and generate physicians with the experience and expertise to diagnose and treat strokes using the latest techniques available. Furthermore, vascular neurology trains neurologists to create educational efforts about stroke and its treatments for other physicians and the public at large.

To satisfy the need for vascular neurologists ("stroke doctors"), neurology departments in academic medical centers throughout the United States have developed vascular neurology programs (usually two to three years of intensive training), which are now recognized by the American Academy of Graduate Medical Education. Vascular neurologists are certified through the American Board of Psychiatry and Neurology.


Adams et. al., Vascular neurology: a new neurologic subspecialty; Neurology 2004 Sep 14;63(5):774-6.

American Stroke Association. www.strokeassociation.org

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