Brain aneurysm repair

Written by Brian Krans | Published on June 1, 2012
Medically Reviewed by George Krucik, MD

Brain Aneurysm Repair

Brain aneurysm repair is a surgical procedure used to treat a bulging blood vessel in the brain that is at risk of rupturing or tearing open.

An aneurysm occurs when the wall of a blood vessel becomes thin and bulges or balloons out. Many aneurysms remain undetected because they often produce no symptoms until they rupture.

This is a serious medical problem that, left untreated, could lead to stroke or brain damage. Because of this, if an unruptured aneurysm is detected, your doctor will often move to repair it as quickly as possible.

Understanding the Basics of Brain Aneurysms

When a blood vessel is weakened or becomes thin, it risks tearing open or rupturing. This weakened or bulging vessel could rupture at any time. If a blood vessel in your brain ruptures, it would cause bleeding in the brain or stroke. This could lead to brain damage or death. Because of this, even an unruptured aneurysm is considered a serious medical emergency.

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

Symptoms most often arise after the aneurysm has ruptured. These symptoms may include:

  • severe headache
  • drooping eyelid
  • seizures
  • impaired speech
  • double vision
  • numbness in the body
  • muscle weakness

Not all brain aneurysms need to be repaired immediately. Those smaller than 3 millimeters are considered less likely to rupture.

The Risks of Brain Aneurysm Repair

Any medical procedure carries certain risks. Aneurysm repair is brain surgery and does have significant risk involved.

Potential risks of brain aneurysm repair include:

  • behavior changes due to neurological damage
  • 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 in a certain part of the brain. They can vary in severity, but they are not always permanent.

The surgery requires that you undergo anesthesia. This can cause allergic reaction or breathing problems, so it’s important to tell your doctor if you’ve ever had a reaction to anesthesia before.

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

How to Prepare for Brain Aneurysm Repair

As brain aneurysm repair is done on an emergency basis, there is often little time to prepare for the procedure. If you’re fortunate enough to have caught an aneurysm before it became an emergency, here are some important steps to take:

  • Tell your doctor about any medications you may be taking, including over-the-counter drugs and nutritional supplements.
  • Quit smoking.
  • Do not 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 any and all instructions from your doctor.

Prior to the surgery, you will be put under general anesthesia, meaning you will be in a deep, painless sleep while the surgery is performed.

How a Brain Aneurysm Repair Is Performed

There are several ways surgeons can correct a brain aneurysm. The method used varies on the size of the aneurysm and other factors.

Clipping

Clipping is the most commonly used procedure. During this procedure, the surgeon makes an incision into your scalp and creates a small hole in your skull. The surgeon then places a small metal clip at the base of the aneurysm to prevent it from rupturing. Your skull is then closed and your scalp is stitched.

Endovascular Repair

A surgeon makes a small incision near your groin. A second incision is made into your artery. Through that incision the surgeon guides a small wire through the artery and to the aneurysm in your brain. A catheter—a thin metal tube—follows the wire. Through this tube, the surgeon installs thin metal wires into the aneurysm. The wire coils into a ball, which initiates a blood clot. This clot will prevent the aneurysm from rupturing.

cPAX

Approved by the U.S. Food and Drug Administration in 2011, the cPAX Aneurysm Treatment System uses a polymer material to stop the blood flow through the aneurysm (Rukovets, 2011). It is set in place with a permanent stent or by a balloon catheter.

After Brain Aneurysm Repair

Your hospital stay may only be a few days if there was no bleeding in the brain prior to surgery. It can be up to one to two weeks if there were complications.

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

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

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