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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 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 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 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 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 before surgery.

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 longer.

You will probably have imaging tests of the blood vessels (angiogram) in the brain before you are sent 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, surgical repair 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 health care provider every year.

References

Bederson JB, Connolly ES Jr., Batjer HH, 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.

Bowles E. Cerebral aneurysm and aneurysmal subarachnoid haemorrhage. Nurs Stand. 2014;28:52-59.

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: Elsevier Saunders; 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.

Tenjin H, Tanigawa, S, Takadou M, et al. Progress in the treatment of unruptured aneurysms. Trends in Neurovascular Interventions. Acta Neurochirurgica Supplement. 2014;119:33-38.


Review Date: 7/30/2014
Reviewed By: Luc Jasmin, MD, PhD, Department of Surgery Providence Hospital, Medford, OR, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, CA, and Department of Oral and Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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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