Brain aneurysm repair is a surgical procedure to correct an
- Bleeding into an area around the brain (also called a
- Bleeding in the brain that forms a collection of blood (hematoma)
Aneurysm repair – cerebral; Cerebral aneurysm repair; Coiling; Saccular aneurysm repair; Berry aneurysm repair; Fusiform aneurysm repair; Dissecting aneurysm repair; Endovascular aneurysm repair – brain; Subarachnoid hemorrhage – aneurysm
You and your health care provider will decide the best way to perform surgery on your aneurysm. There are two common methods used to repair an aneurysm:
Clipping used to be the most common way to repair an aneurysm. This is done during an
Endovascular repair, most often using a “coil” or coiling and stenting (mesh tubes), is a less invasive way to treat some aneurysms. It is now done in more than half of patients.
During aneurysm clipping:
You are given
general anesthesiaand a breathing tube.
Your scalp, skull, and the coverings of the brain are opened up.
A metal clip is placed at the base (neck) of the aneurysm to prevent it from breaking open (bursting).
During endovascular repair of an aneurysm:
- The procedure is usually done in the radiology section of the hospital.
- You may have general anesthesia and a breathing tube. Or, you may be given medicine to relax you, but not enough to put you to sleep.
- A catheter is guided through a small cut in your groin to an artery and then to the small blood vessels in your brain where the aneurysm is located.
- Thin metal wires or glue are put into the aneurysm. They then coil up into a mesh ball. Blood clots that form around this coil prevent the aneurysm from breaking open and bleeding. Sometimes stents (mesh tubes) are also put in to hold the coils in place.
- During and right after this procedure, you may be given a blood thinner called heparin.
Why the Procedure Is Performed
If an aneurysm in the brain ruptures, it is an emergency that needs medical treatment, often surgery. Endovascular repair is more often used when this happens.
A person may have an aneurysm but have no symptoms. This kind of aneurysm may be found when an
- Not all aneurysms need to be treated right away. Aneurysms that have never bled and are very small (less than 7 mm at their largest point) do not need to be treated right away. These aneurysms are less likely to break open.
- Your doctor will help you decide whether it is safer to have surgery to block off the aneurysm before it can break open (rupture).
Risks for any anesthesia are:
- Reactions to medications
Possible risks of brain surgery are:
Blood clotor bleeding in the brain
- Brain swelling
- Infection in the brain, or parts around the brain such as the skull or scalp
- Surgery on any one area of the brain may cause problems with speech, memory, muscle weakness, balance, vision, coordination, and other functions. These problems may be mild or severe, and they may last a short while or they may not go away.
Signs of brain and nervous system (neurological) problems include:
Problems noticing things around you
- Speech problems
Vision problems(from blindness to problems with side vision)
Before the Procedure
This procedure is often performed on an emergency basis. If it is not an emergency:
- Tell your doctor or nurse what drugs or herbs you are taking and if you have been drinking a lot of alcohol.
- Ask your doctor which drugs you should still take on the day of the surgery.
- Always try to
- You will usually be asked not to eat or drink anything for 8 hours before the surgery.
- Take the drugs your doctor told you to take with a small sip of water.
- Your doctor or nurse will tell you when to arrive.
After the Procedure
A hospital stay for endovascular repair of an aneurysm may be as short as 1 to 2 days if there was no bleeding beforehand.
The hospital stay after craniotomy and aneurysm clipping is usually 4 to 6 days. When bleeding or other complications occur before or during surgery, the hospital stay can be 1 to 2 weeks, or more.
You will probably have an x-ray test of the blood vessels in the brain (
Ask your doctor if it will be safe for you to have MRI scans in the future.
After successful surgery for a bleeding aneurysm, it is uncommon for it to bleed again.
The outlook also depends on whether any brain damage occurred from bleeding before, during, or after the surgery.
Most of the time, open surgery or endovascular repair can prevent a brain aneurysm that has not caused symptoms from becoming larger and breaking open.
You may have more than one aneurysm. After endovascular treatment (coiling), you will need to be seen by your health care provider every year.
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