Cerebral Aneurysm Surgical Repair
A cerebral aneurysm is the ballooning of an artery at a region of weakness or thinning of the blood vessel walls, from the pressure created by the blood within the artery. This bulging of the vessel may compress and damage surrounding brain tissue or rupture, causing blood to collect in the surrounding tissues (hemorrhage). Cerebral aneurysms can lead to complications such as stroke (death of brain tissue), subarachnoid hemorrhage (blood collected between the brain and skull) and death in severe cases.
Small aneurysms with minimal symptoms are usually monitored closely. Treatment depends on the size and location of the aneurysm. Surgery is indicated to treat ruptured or large aneurysms and involves two techniques.
Microvascular clipping is a technique that involves identifying the area of the artery that forms the neck of the aneurysm and clipping it with a metal clip to block blood flow into the aneurysm and prevent bleeding. If the artery is significantly damaged by the aneurysm, the entire artery may be clamped and the area of the aneurysm bypassed with a vessel graft. This involves cutting through the skull to access the aneurysm.
Alternatively, your doctor may perform a minimally invasive procedure called endovascular embolization where a catheter is inserted through a vessel in your groin and advanced under X-ray imaging to reach the aneurysm. Metallic coils are inserted through the catheter and released at the aneurysm to clot the blood, block it completely and destroy the aneurysm. Endovascular embolization may require repeat procedures to effectively control the aneurysm. Following treatment, you are advised to remain in bed until the bleeding is controlled. It can take months to recover from this surgery.