Surgery for a Brain Aneurysm
Surgery for an aneurysm is performed as soon as possible. This is often within 72 hours of the diagnosis. One of 2 types of surgery is generally used. In open surgery, a portion of your skull is removed. In an endovascular procedure, your surgeon goes through the blood vessel leading toward your aneurysm. Treatment may not reverse any damage already done. The goal is to prevent further bleeding.
Your surgeon reaches your brain through your skull. First, you receive sleep medicine (anesthesia) during the surgery. Then, after a scalp incision, small holes are made in your skull. The bone between the holes is cut and lifted away. The dura (a membrane) is peeled back. Trapped blood and cerebrospinal fluid may be removed. Your surgeon closes off (clips) your aneurysm. Or the artery leading to the aneurysm is sealed off (occluded). The dura and the piece of skull are put back in place. A device that measures the pressure inside your skull or that drains your spinal fluid may be left in one of the small holes.
Clipping the Aneurysm
Your surgeon may put a clip on your aneurysm where it bulges from the artery. This keeps blood from entering the aneurysm. As a result, future bleeding is prevented and nearby brain tissue is protected from further damage. Your surgeon makes sure that the clip is secure before finishing the surgery. This method, performed through open surgery, is considered the only true cure for a brain aneurysm.
Occlusion and Bypass
It may be best to stop blood flow through the artery leading to your aneurysm. This is called occlusion. In most cases, it is done as open surgery. Sometimes occlusion is combined with a bypass. A bypass reroutes blood around the occlusion. It brings the blood to the part of your brain that had been fed by the damaged artery. A small blood vessel is used for the bypass.
An endovascular procedure may be best for some aneurysms. This is done in an X-ray lab by a specially trained doctor (interventional neuroradiologist). Some neurosurgeons and neurologists may also perform this operation. Anesthesia is given to block pain. Then a catheter is guided through the arteries from your groin to your brain. Platinum coils are released into your aneurysm. The coils cause a blood clot to form in your aneurysm, which seals it off. This s a very effective and less risky approach to treating aneurysms than open surgery. However, there is a slightly greater risk of the aneurysm re-forming.
Risks and Complications Include:
Brain swelling or bleeding
Weakness, paralysis, or loss of vision
Confusion, loss of speech, loss of memory
Seizures (jerking or abnormal movements, loss of consciousness)