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Brain aneurysm repair

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

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:

Description

There are two common methods used to repair an aneurysm:

During aneurysm clipping:

During endovascular repair (surgery) 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 in the hospital. Often a rupture is treated with surgery, especially endovascular surgery.

A person may have an unruptured 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 that 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, such as narrowed blood vessels in the brain or a buildup of fluid in the brain, 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, and possibly once a year for a few years.

Follow instructions on caring for yourself at home.

Ask your doctor if it will be safe for you to have imaging tests such as angiogram, CT angiogram, or 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.

Related Information

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Communicating with someone with aphasia
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Communicating with someone with dysarthria
Caring for muscle spasticity or spasms
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Brain aneurysm repair - discharge
Brain surgery - discharge
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Stroke - discharge

References

Altschul D, Vats T, Unda S. Endovascular treatment of brain aneurysms. In: Ambrosi PB, ed. New Insight Into Cerebrovascular Diseases - An Updated Comprehensive Review. www.intechopen.com/books/new-insight-into-cerebrovascular-diseases-an-updated-comprehensive-review/endovascular-treatment-of-brain-aneurysms. IntechOpen; 2020:chap: 11. Reviewed August 1, 2019. Accessed May 18, 2020.

American Stroke Association website. What you should know about cerebral aneurysms. www.stroke.org/en/about-stroke/types-of-stroke/hemorrhagic-strokes-bleeds/what-you-should-know-about-cerebral-aneurysms#. Updated December 5, 2018. Accessed July 10, 2020.

Le Roux PD, Winn HR. Surgical decision making for the treatment of intracranial aneurysms. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 379.

National Institute of Neurological Disorders and Stroke website. Cerebral aneurysms fact sheet. www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Cerebral-Aneurysms-Fact-Sheet. Updated March 13, 2020. Accessed July 10, 2020.

Spears J, Macdonald RL. Perioperative management of subarachnoid hemorrhage. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 380.

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Review Date: 5/18/2020  

Reviewed By: Luc Jasmin, MD, PhD, FRCS (C), FACS, Department of Surgery, Johnson City Medical Center, TN; Department of Surgery St-Alexius Medical Center, Bismarck ND; Department of Neurosurgery Fort Sanders Medical Center, Knoxville TN, Department of Neurosurgery UPMC Williamsport PA, Department of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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