Advanced Vascular Neurology Diagnosis & Treatment
Diagnose the Cerebrovascular Disease. Localize the Neurological Injury. Target It Precisely.
Vascular neurological disorders can injure virtually any region of the brain and produce neurological symptoms ranging from obvious acute deficits to subtle cognitive, visual, vestibular, sensory, motor, or behavioral changes. Dr. Funk diagnoses cerebrovascular and neurovascular disorders including ischemic stroke and cerebral infarction, transient ischemic attack (TIA), lacunar infarction, cerebral small vessel disease, hemorrhagic stroke, and other cerebrovascular abnormalities. His approach extends beyond determining whether a vascular event occurred to identifying where the neurological injury occurred, why it occurred, what mechanisms contributed to it, and what can be done to reduce future risk and rehabilitate the affected nervous system.
Advanced neuroimaging is central to this process. Dr. Funk orders appropriate neuroimaging and vascular imaging when clinically indicated and personally reviews and interprets patients’ neurological imaging as part of his diagnostic evaluation. He correlates MRI and other imaging findings with the neurological examination, history, symptom evolution, vascular anatomy, and other objective findings. This becomes particularly important when a cerebral infarction, small vessel lesion, or other vascular abnormality is subtle, has been previously missed, or does not adequately correlate with a prior interpretation. Rather than relying exclusively on a radiology report, Dr. Funk analyzes the actual neuroimaging to identify cerebrovascular pathology and determine its neurological significance.
Diagnosis is only the beginning. Dr. Funk investigates the potential etiology and mechanisms underlying cerebrovascular disease. Depending on the patient, this may include advanced laboratory investigation of vascular, metabolic, inflammatory, hematological, coagulation, endothelial, autoimmune, endocrine, nutritional, and other clinically relevant contributors to cerebrovascular risk. Dr. Funk has developed an advanced cerebrovascular accident and stroke risk-stratification laboratory panel designed to investigate potential contributors to cerebrovascular disease beyond routine vascular screening when clinically appropriate.
A polysubspecialty approach is particularly important because cerebrovascular disease often intersects with multiple neurological and physiological systems. Dr. Funk integrates Vascular Neurology with Neuroimaging, Neuroimmunology, Neuroendocrinology, Dysautonomia, Neuro-Ophthalmology, Vestibular Neurology, Brain Injury Medicine, Cognitive and Memory Disorders, and other relevant neurological subspecialties to determine how vascular pathology fits within the patient's complete neurological condition.
Treatment addresses both the underlying vascular risk and the neurological consequences of the vascular injury. Dr. Funk educates patients regarding relevant medication considerations and refers to or co-manages with appropriate prescribing clinicians, primary care physicians, cardiologists, vascular specialists, hematologists, or other specialists when prescription medication or additional medical management is indicated. When appropriate, he may also recommend individualized over-the-counter medications, nutraceuticals, dietary strategies, and other interventions intended to support vascular health, cerebral blood flow, metabolic function, and modifiable cerebrovascular risk factors.
For patients who have sustained a stroke or other focal cerebrovascular injury, treatment also follows the neurological localization. Dr. Funk determines which cortical regions, subcortical structures, nuclei, white-matter pathways, cerebellar systems, brainstem structures, sensory and motor pathways, and interconnected neural networks have been affected. He then develops individualized neurological rehabilitation and neuromodulation directed toward the dysfunctional circuitry and the specific neurological deficits identified during examination.
Depending on the neurological localization and the patient's clinical status, rehabilitation may incorporate precisely selected motor and sensory rehabilitation, vestibular stimulation, neuro-optometric rehabilitation, balance and coordination rehabilitation, peripheral nerve stimulation, transcutaneous auricular vagus nerve stimulation (taVNS), transcranial photobiomodulation, and other targeted neuromodulation strategies designed to promote neuroplasticity and neurological recovery.
The objective is not simply to diagnose that a stroke or vascular disorder occurred. Dr. Funk identifies the cerebrovascular pathology, investigates why it developed, determines the patient's ongoing cerebrovascular risk, localizes the neurological systems that have been injured, and develops an individualized strategy to address modifiable vascular mechanisms while rehabilitating the specific brain regions, pathways, and neural networks affected by the disease.
