Brain aneurysm repair

Definition

Brain aneurysm repair is surgery to correct an aneurysm. This is a weak area in a blood vessel wall that causes the vessel to bulge or balloon out and sometimes burst (rupture). It may cause:

Alternative Names

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

Description

There are 2 common methods used to repair an aneurysm:

During aneurysm clipping:

During endovascular repair of an aneurysm:

Why the Procedure Is Performed

If an aneurysm in the brain breaks open (ruptures), it is an emergency that needs medical treatment. Often a rupture is treated with surgery. Endovascular repair is more often used when this happens.

A person may have an aneurysm without any symptoms. This kind of aneurysm may be found when an MRI or CT scan of the brain is done for another reason.

Risks

Risks of anesthesia and surgery in general are:

Risks of brain surgery are:

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. They may last a short while or they may not go away.

Signs of brain and nervous system (neurological) problems include:

Before the Procedure

This procedure is often done as an emergency. If it is not an emergency:

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 before surgery.

The hospital stay after craniotomy and aneurysm clipping is usually 4 to 6 days. If there is bleeding or other problems, the hospital stay can be 1 to 2 weeks, or longer.

You will probably have imaging tests of the blood vessels (angiogram) in the brain before you are sent home.

Follow instructions on caring for yourself at home.

Ask your doctor if it will be safe for you to have MRI scans of the head in the future.

Outlook (Prognosis)

After successful surgery for a bleeding aneurysm, it is uncommon for it to bleed again.

The outlook also depends on whether brain damage occurred from bleeding before, during, or after surgery.

Most of the time, surgery can prevent a brain aneurysm that has not caused symptoms from becoming larger and breaking open.

You may have more than one aneurysm or the aneurysm that was coiled might grow back. After coiling repair, you will need to be seen by your provider every year.

References

Bowles E. Cerebral aneurysm and aneurysmal subarachnoid haemorrhage. Nurs Stand. 2014;28:52-59. PMID: 24749614 www.ncbi.nlm.nih.gov/pubmed/24749614.

Connolly ES Jr, Rabinstein AA, Carhuapoma JR, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/american Stroke Association. Stroke. 2012;43:1711-1737. PMID: 22556195 www.ncbi.nlm.nih.gov/pubmed/22556195.

Szeder V, Tateshima S, Duckwiler GR. Intracranial aneurysms and subarachnoid hemorrhage. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 67.

Tenjin H, Tanigawa, S, Takadou M, et al. Progress in the treatment of unruptured aneurysms. Acta Neurochir Suppl. 2014;119:33-38. PMID: 24728629 www.ncbi.nlm.nih.gov/pubmed/24728629.