Brain aneurysm repair is a surgical procedure used to treat a bulging blood vessel in the brain that’s 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 have no symptoms until they rupture.
If it’s left untreated, a brain aneurysm could lead to stroke or brain damage. If an aneurysm that hasn’t ruptured is found, your doctor will repair it as quickly as possible.
When a blood vessel is weakened or becomes thin, 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 death. Because of this, even an aneurysm that hasn’t ruptured is considered a serious medical emergency.
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. 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:
- a severe headache
- a drooping eyelid
- 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.
Risks of Surgery
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 damage
- blood clots
- brain swelling
- speech and vision problems
Some neurological problems, such as those affecting memory, coordination, or other functions may be present after surgery. They can vary in severity. They’re not always permanent.
The surgery requires that you undergo general anesthesia, meaning you’ll be put in 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 overshadows the risks associated with the surgery.
Since brain aneurysm repair is done on an emergency basis, there’s often little time to prepare for it. If your aneurysm is caught before it becomes an emergency, here 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 instructions from your doctor.
There are several ways surgeons can correct a brain aneurysm. The method used depends on the size of the aneurysm, among other factors.
Clipping is the most commonly used procedure. During this procedure, your 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.
During an endovascular repair, your surgeon makes a small incision near your groin. A second incision is made into your artery. Your surgeon guides 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, 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.
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. It’s set in place with a permanent stent or by a balloon catheter.
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 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.