Conditions & Treatments

Aneurysm & Hemorrhage

  • Cerebral Aneurysm — A weak or bulging spot in a brain artery that can rupture without warning. As a dual-trained neurosurgeon and neurointerventionalist, Dr. Snelling offers microsurgical clipping, endovascular coil embolization, flow diversion, and intrasaccular flow disruption — selecting the safest and most durable approach based on each aneurysm's anatomy, location, and rupture status.

  • Fusiform & Partially Thrombosed Aneurysm — Complex aneurysms that don't conform to standard shape and often require advanced flow diversion strategies or combined surgical and endovascular approaches.

  • Subarachnoid Hemorrhage (SAH) — Bleeding into the space surrounding the brain, most often from a ruptured aneurysm. Requires immediate intervention and comprehensive neurovascular expertise across both surgical and endovascular disciplines.

  • Intracerebral Hemorrhage (ICH) — Bleeding directly into brain tissue requiring rapid neurosurgical assessment and intervention. Treatment may include minimally invasive hematoma evacuation to relieve pressure and limit injury, as well as endovascular evaluation to identify and treat an underlying vascular cause such as an AVM, fistula, or aneurysm.

  • Subdural Hematoma (SDH) — A collection of blood between the brain and its outer covering. Dr. Snelling offers both surgical drainage and middle meningeal artery embolization — a minimally invasive procedure that reduces recurrence by eliminating the arterial source feeding chronic collections.

  • Cranial Nerve Palsy from Aneurysm — Compression of cranial nerves, most commonly the oculomotor nerve from a posterior communicating artery aneurysm, causing double vision or a drooping eyelid. Prompt treatment of the underlying aneurysm can relieve compression and restore function.

Stroke & Ischemia

  • Acute Ischemic Stroke — A blocked artery cutting off blood flow to the brain. Time is brain. Dr. Snelling performs mechanical thrombectomy — minimally invasive clot retrieval — to restore circulation and limit permanent damage.

  • Intracranial Stenosis & Atherosclerosis — Narrowing of arteries inside the skull due to plaque buildup, increasing stroke risk. Treated with medical management, intracranial angioplasty, or stenting depending on severity and location.

  • Carotid Artery Disease — Narrowing, dissection, or occlusion of the carotid artery supplying the brain. Dr. Snelling offers both open carotid endarterectomy and minimally invasive carotid artery stenting — selecting the safest and most effective approach for each patient.

  • Vertebral Artery Stenosis & Dissection — Disease or injury of the arteries supplying the back of the brain. Treated medically or with endovascular angioplasty and stenting depending on presentation and stroke risk.

  • Cerebral Vasospasm — Dangerous arterial narrowing that can follow subarachnoid hemorrhage, threatening delayed stroke. Managed through endovascular techniques including intra-arterial spasmolytic therapy and balloon angioplasty.

  • Cerebral Vasculitis — Inflammation of brain blood vessels that can cause stroke and neurological decline. Requires specialized neurovascular evaluation including diagnostic angiography.

  • Moyamoya Disease — A rare progressive narrowing of major brain arteries that increases stroke and hemorrhage risk. Dr. Snelling performs both direct and indirect cerebral bypass surgery to restore blood flow, as well as comprehensive endovascular evaluation and management.

  • Fibromuscular Dysplasia (FMD) — A non-inflammatory arterial disease affecting the carotid and vertebral arteries, associated with dissection and stroke risk. Managed with angioplasty or medical therapy.

Vascular Malformations

  • Arteriovenous Malformation (AVM) — Brain & Spine — Abnormal tangles of blood vessels that bypass normal circulation and can bleed. Treatment requires the full spectrum of options — open microsurgical resection, endovascular embolization, and stereotactic radiosurgery — often in combination. Having a surgeon trained across all three disciplines means the treatment plan is never limited by the tools available.

  • Dural Arteriovenous Fistula (DAVF) — Abnormal connections between arteries and veins within the dura that can cause progressive neurological injury, hemorrhage, or venous hypertension. Dr. Snelling treats cranial DAVFs with both surgical disconnection and endovascular embolization depending on fistula grade and angioarchitecture.

  • Spinal Arteriovenous Fistula — Abnormal arteriovenous connections along the spine that cause progressive myelopathy. Most commonly Type I dural fistulas, treated with microsurgical ligation — the most durable long-term solution — or endovascular embolization when anatomy permits.

  • Cavernous Malformation — Clusters of abnormal blood vessels prone to repeated small hemorrhages causing progressive neurological injury. Treated with microsurgical resection or laser interstitial thermal therapy depending on location and patient profile. Dr. Snelling has experience resecting cavernous malformations in surgically challenging locations, including the brainstem — among the most technically demanding operations in neurosurgery.

  • Carotid Cavernous Fistula — An abnormal connection between the carotid artery and the cavernous sinus, often causing eye symptoms including proptosis and double vision. Treated with endovascular embolization.

  • Hereditary Hemorrhagic Telangiectasia (HHT) — A genetic disorder causing abnormal blood vessel formation throughout the body including the brain and spine. Requires specialized neurovascular surveillance and intervention.

Venous Disease

  • Cerebral Venous Sinus Thrombosis (CVST) — Clotting of the brain's venous drainage system causing elevated pressure and stroke. Treated with anticoagulation and endovascular intervention when necessary.

  • Venous Sinus Stenosis & Idiopathic Intracranial Hypertension (IIH) — Elevated brain pressure from venous outflow obstruction. Treated with venous sinus stenting to restore normal drainage and relieve symptoms including headache and vision loss.

  • Pulsatile Tinnitus — A rhythmic sound in the ear that can signal an underlying vascular abnormality. Comprehensive neurovascular evaluation including angiography can identify and treat the source.

Skull Base & Tumors

  • Meningioma — Tumors arising from the lining of the brain, including complex anterior skull base locations such as the olfactory groove and sphenoid wing. Dr. Snelling performs preoperative tumor embolization to improve surgical safety, followed by resection when indicated.

  • Tumor Embolization — A minimally invasive endovascular procedure performed before surgery to reduce blood supply to highly vascular tumors, improving surgical safety and outcomes.

  • Stereotactic Radiosurgery — Non-invasive, highly focused radiation used to treat brain tumors, AVMs, and metastases with millimeter precision.

Epistaxis & Head and Neck Vascular Disease

  • Epistaxis & Head and Neck Vascular Malformations — Severe or recurrent nosebleeds and vascular anomalies of the head and neck treated with targeted endovascular embolization to control hemorrhage.

Cushing's Disease

  • Inferior Petrosal Sinus Sampling (IPSS) — A specialized endovascular procedure used to localize the source of excess cortisol production in Cushing's disease, guiding surgical planning for optimal outcomes.

Surgical & Endovascular Expertise

Open Neurosurgery

  • Microsurgical Aneurysm Clipping

  • Cerebral Bypass — Direct & Indirect

  • AVM Resection

  • Cavernous Malformation Resection, including Brainstem

  • Carotid Endarterectomy

  • Meningioma Resection

  • Craniotomy for Hemorrhage

Endovascular & Interventional

  • Diagnostic Cerebral & Spinal Angiography

  • Mechanical Thrombectomy

  • Coil Embolization

  • Flow Diversion

  • Intrasaccular Flow Disruption

  • Stent & Balloon-Assisted Coiling

  • Intracranial Angioplasty & Stenting

  • Carotid Artery Stenting

  • MMA Embolization

  • Tumor & DAVF Embolization

  • Venous Sinus Stenting

  • Inferior Petrosal Sinus Sampling (IPSS)

  • Stereotactic Radiosurgery (SRS, CyberKnife)