Brain Aneurysm Repair

When a blood vessel becomes thin or weak and develops an aneurysm, it can tear or rupture at any time. If a blood vessel in your brain ruptures, it can cause bleeding in the brain or stroke. This could lead to brain damage or even death. Even an aneurysm that hasn’t ruptured is considered a serious medical condition.

Before an aneurysm ruptures, you could have headaches, eye pain, neck pain, or you may have no symptoms at all. Because an aneurysm can happen and show no symptoms, they’re often found by chance when your doctor is looking for something else. An aneurysm may appear on an imaging test like an MRI or CT scan.

Symptoms most often arise after an aneurysm ruptures. These symptoms may include:

• a severe headache
• a drooping eyelid
• seizures
• impaired speech
• double vision
• numbness in the body
• muscle weakness
• decreased level of alertness
• coma

Not all brain aneurysms need to be repaired immediately. The likelihood of a brain aneurysm rupturing depends on your age, medical history, the size of the aneurysm, and its location. Generally, smaller aneurysms and aneurysms found in the arteries toward the front side of the brain are less likely to rupture. Those smaller than 7 millimeters are considered less likely to rupture. Your doctor will still likely recommend close follow-up to make sure the aneurysm is not getting larger.

Any medical procedure carries certain risks. Since aneurysm repair is brain surgery, it does involve significant risk.

Potential risks of brain aneurysm repair include:

• behavior changes due to neurological injury
• blood clots
• brain swelling
• confusion
• infection
• seizures
• speech and vision problems
• stroke
• weakness

Some neurological problems, such as those affecting memory, coordination, or other functions may be present after surgery. They can vary in severity and they’re not always permanent.

The surgery requires that you undergo general anesthesia. This means you’ll be put into a deep sleep. If you’ve ever had a reaction to anesthesia, like breathing problems, make sure to tell your doctor.

In almost all cases, the risk of not having brain aneurysm repair greatly outweighs the risks associated with the surgery.

Brain aneurysm repair is done on an emergency basis so there’s often little time to prepare for it. If your doctor catches your aneurysm before it becomes an emergency, there are some important steps to take:

• Tell your doctor about any medications you’re taking, including over-the-counter drugs and nutritional supplements.
• Quit smoking if you smoke.
• Don’t eat or drink anything eight hours before the procedure.
• Take any medications your doctor gives you.
• Stop taking any medications your doctor instructs you not to take.
• Follow all other instructions from your doctor.

There are several ways surgeons can correct a brain aneurysm. The method the surgeon uses depends on the size, shape, and location of the aneurysm, among other factors.

Clipping

During this procedure, your surgeon will make an incision into your scalp and create a small hole in your skull. The surgeon will then place a small metal clip at the base of the aneurysm to prevent it from rupturing. They will then close your skull and stitch your scalp.

Endovascular repair

During an endovascular repair, your surgeon will insert a small wire into an artery in your groin. Your surgeon will guide a small wire through that incision and through the artery that leads to the aneurysm in your brain. A catheter, which is a thin tube, follows the wire. Through this tube, your surgeon will install thin metal wires into the aneurysm. The wire will coil into a ball and initiate a blood clot. This clot will prevent the aneurysm from rupturing.

Your hospital stay may only be a few days if there was no bleeding in your brain before surgery. Your stay could be one to two weeks if there were complications.

Brain aneurysm repair typically doesn’t involve any other surgeries, but your doctor may want to repeat CT scans or MRI of your brain in following appointments to ensure there aren’t any other concerns.

Your treatment following surgery will focus on the underlying cause of the aneurysm, such as hardening of the arteries or high blood pressure.