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Brain aneurysm repair

Definition

Brain aneurysm repair is a surgical procedure to correct an aneurysm, a weak area in a blood vessel wall that causes the blood 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

You and your health care provider will decide the best way to perform surgery on your aneurysm. There are two 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 ruptures, it is an emergency that needs medical treatment, often surgery. Endovascular repair is more often used when this happens.

A person may have an aneurysm but have no symptoms. This kind of aneurysm may be found when an MRI or CT scan of the brain is done for another reason.

Risks

Risks for any anesthesia are:

Possible risks of brain surgery are:

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

Before the Procedure

This procedure is often performed on an emergency basis. 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 beforehand.

The hospital stay after craniotomy and aneurysm clipping is usually 4 to 6 days. When bleeding or other complications occur before or during surgery, the hospital stay can be 1 to 2 weeks, or more.

You will probably have an x-ray test of the blood vessels in the brain (angiogram) before you are sent home.

Ask your doctor if it will be safe for you to have MRI scans 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 any brain damage occurred from bleeding before, during, or after the surgery.

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

You may have more than one aneurysm. After endovascular treatment (coiling), you will need to be seen by your health care provider every year.

References

Bederson JB, Connolly ES Jr., Batjer HH, Dacey RG, Dion JE, Diringer MN, et al. American Heart Association Guidelines for the management of aneurysmal subarachnoid hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 2009;40:994-1025.

Brinjikji W, Lanzino G, Cloft HJ, Rabinstein A, Kallmes DF. Endovascular treatment of very small (3 mm or smaller) intracranial aneurysms: report of a consecutive series and a meta-analysis. Stroke. 2010;41:116-121.

Mack W, Dusick JR, Martin N, Gonzalez N. Principles of endovascular therapy. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 47.

Meyers PM, Schumacher HC, Higashida RT, Barnwell SL, Creager MA, Gupta R, et al. American Heart Association Indications for the performance of intracranial endovascular neurointerventional procedures: a scientific statement from the American Heart Association Council on Cardiovascular Radiology and Intervention, Stroke Council, Council on Cardiovascular Surgery and Anesthesia, Interdisciplinary Council on Peripheral Vascular Disease, and Interdisciplinary Council on Quality of Care and Outcomes Research. Circulation. 2009;119:2235-2249.


Review Date: 7/19/2012
Reviewed By: Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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