How Are Brain Aneurysms Treated?
How a brain aneurysm is treated depends on the size of the aneurysm, where in the brain it is located, and the age and overall health of the patient. Your doctor will consider how to treat your brain aneurysm when the results of the scans and other tests are completed. Having a brain aneurysm doesn’t always mean that surgery is necessary.
If your brain aneurysm is small, your doctor may take the “wait and see” approach to observe the aneurysm and your overall condition. There is always some risk involved when one undergoes surgery to treat or remove a brain aneurysm; however, if the aneurysm is large, the benefit of surgery may outweigh the risks. Surgery will most likely be recommended if you are experiencing significant symptoms, such as extreme headaches, nausea and vomiting. Surgery may also be recommended if a brain aneurysm ruptures.
Surgeries to treat a brain aneurysm
According to the Cerebral aneurysm fact sheet, unruptured aneurysms can be treated with microvascular coil embolization, Microvascular clipping, and Microvascular occlusion. These procedures will be discussed below:
Endovascular coil embolization – With endovascular coil embolization, a very small catheter is advanced into the artery in the vicinity of the aneurysm. Tiny soft platinum coils (thinner than a strand of hair) are advanced through the catheter and into the aneurysm, which will relieve some of the pressure within the aneurysm. Once the coil is in place, its position is confirmed with an X-ray or angiogram. With the coils in place, the aneurysm is not as likely to rupture.
Microvascular clipping – Microvascular clipping is a surgical procedure done with a microscope. In this procedure, a small window is cut into the skull to expose the brain. A tiny clip is clamped onto the aneurysm’s base. Clamping the base, or neck, of the aneurysm will isolate it from general circulation. Microvascular clipping is very effective to prevent rupture of the brain aneurysm. The aneurysm isn’t likely to return, if its neck is completely clipped off.
Microvascular occlusion – A microvascular occlusion is similar to Microvascular clipping, except that the entire artery is clamped off that leads to the aneurysm. With occlusion surgery, circulation is sometimes rerouted by creating a bypass. A bypass is created by grafting another blood vessel to the artery that is occluded.
After having surgery, the patient should be on complete bed rest until the bleeding has stopped. Underlying conditions which could negatively influence a brain aneurysm should be treated. For instance, if you have hypertension, it must be treated to prevent untoward effects on the brain aneurysm. If you are prone to having seizures, your doctor will likely order anticonvulsants. After surgery, you may be put on light sedation, and you may be put on calcium channel blockers to prevent vasospasms (spasms of the blood vessels). Your doctor’s primary goal is to treat the brain aneurysm while doing no harm to the surrounding tissues.