ALERT CONTENT PLACEHOLDER

About Us

Location

Toronto Western Hospital
West Wing – 4th Floor


Contact

Phone: 416 603 5463​

Referral Fax: 416 ​603 6282


Hours

Monday – Friday
8:00 am – 4:00 pm​


Location

Contact

Hours

Location

Contact

Hours

Location

Contact

Hours


Referrals

For urgent referrals, please contact the neurosurgeon on-call through UHN locating at 416 340 3155

Please note that only physicians may send a referral. Referrals must be addressed to a specific neurosurgeon. Please fax the following to 416 603 ​6282 when referring your patient:

  • A referral letter
  • Clinical notes
  • All relevant diagnostic tests

The neurosurgeon's office will call you with information about the patient's first appointment. The referring physician's office is responsible for providing the patient with the appointment information, including time and location, and important documents, test results and imaging that they must bring.

Please note that clinic appointments may be virtual visits. The clinic team will let you know what type of appointment is appropriate for your care. Learn more about virtual visits at UHN »

What We Do

A brain aneurysm is a bulge or ballooning of the wall of a blood vessel in the brain. As blood flows through the vessels, it passes by the bulging wall and over time, the pressure can weaken it. Though rare, the steady pressure can cause the aneurysm to rupture. Brain aneurysms affect mostly adults between the ages of 40 to 60, with a higher prevalence in women. The cause of most aneurysms is unknown, although there's evidence they may be inherited.

Our team has many different health care practitioners who can diagnose a brain aneurysm and determine the best course of treatment. The first step is to get a visual picture of your brain, the blood vessels and the aneurysm. After the tests are completed, a member of the team will discuss with you and your family or caregiver your tr​eatment options.

Treatment Information

A treatment for an aneurysm depends on a variety of factors, including your age, overall health, if the aneurysm is producing symptoms, and the size, location and shape. Some aneurysms require a single treatment, while others are complicated because of their location, shape or size. They may require more than one treatment type. The health care practitioner will provide your options to you during your clinic visit. The role of treatment is to prevent the risk of a rupture, but keep in mind – the rate of rupture is very low.

An aneurysm that's less than 5 mm in size or one without symptoms is considered too small to treat, and its potential to rupture is extremely unlikely. A periodic test, such as a CT Angiography, may be recommended to check whether it's grown in size.

Endovascu​lar Treatment
This treatment uses a platinum coil sent through an artery in the groin to the aneurysm to pack it off. Sometimes a wire mesh is placed into the aneurysm to change its shape.​

Surgical Tr​​​eatment​
This kind of treatment includes "clipping" the aneurysm with a small titanium clip that looks like a small set of tweezers. It's placed on the "neck" of the aneurysm or the area where it bubbles out from the artery. If the situation is complicated, the surgeon can create a detour for the blood and a small artery or vein is sewn around the aneurysm.

For more information, please see the videos in the section "Treatment" and click on which video you want to watch.

To watch a video of the procedure, please cli​ck her​e​.

The Krembil Brain Institute was the first facility in Canada to perform surgery with a procedure called ELANA (Excimer Laser Assisted Non-occlusive Anastomosis). It uses a laser to treat complex brain aneurysms and blocked arteries to the brain.

The ELANA technique allows neurosurgeons to avoid using regular bypass surgery, which involves clamping an artery to create a new source of blood flow. In the conventional operation, the clamps may have to stay on for a half-hour or even an hour, and that's where the risk comes in – cutting off blood flow to the brain can cause a stroke that may leave permanent damage. This also leaves surgeons with an extremely small window of time to complete the bypass. But by using this revolutionary laser technique, a neurosurgeon can maintain blood flow at all times.

Tests

There are a few different tests that can provide the team with the necessary information needed. A health care practitioner may order more than one. Some of these tests can be completed by your family doctor before your first clinic visit.

How to Prepare

Your first appointment can take 2 hours or more. We'll review your test results with you and answer all your questions. We may also arrange to have some tests done during your clinic visit, such as a CT Scan. If other tests are needed, we'll discuss them with you at this time, so please remember to bring your questions. Follow-up appointments usually take 15 to 45 minutes. During this visit, we may discuss treatment results and your options. You may meet different members of the team.

Learn more about what you can expect when you have a clinic appointment.​

Health Information

Materials and Resources to Help You

Resources from the Patient & Family Education Program PDF Icon

    Visit our health information section.​​​​​​​​​​​

    Our Team

    Meet Our Team

    Our team includes:

    • Neurosurgeons
    • Neuroradiologists
    • Neurologists
    • Radiosurgeon
    • Radiation oncologists
    • Nurse Practitioner
    • Clinical Nurse Coordinator
    • Clinical Research Coordinator

    Patient Care Coordinator: Gail Nixon

    Neuroradiologists

    Medical Imaging Radiologist: Dr. Ronit Agid

    Medical Imaging Radiologist: Dr. Richard Farb

    Medical Imaging Radiologist: Dr. Robert Willinsky

    Surgeons

    Neurosurgeon: Dr. Ivan Radovanovic

    Vascular Surgeon: Dr. Miranda Witheford

    Neurologists

    Neurologist: Dr. Joanna Schaafsma

    Nurse Practitioner

    Adult & Practice Lead: Stephanie van Rooy

    Clinic Support

    Clinical Nurse Coordinator, specializing in Neuroradiology

    Clinical Research Coordinator​​

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