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Aneurysm in the brain - Treatment

Alternative Names

Aneurysm - cerebral; Cerebral aneurysm

Treatment:

Two common methods are used to repair an aneurysm:

  • Clipping is the most common way to repair an aneurysm. this is done during open brain surgery. See also: Brain surgery (craniotomy)
  • Endovascular repair, most often using a "coil" or coiling, is a less invasive way to treat some aneurysms.

If an aneurysm in the brain ruptures, it is an emergency that needs medical treatment and often requires surgery. Endovascular repair is more often used when this happens.

Even if there are no symptoms, your doctor may order treatment to prevent a future, possibly fatal rupture.

Not all aneurysms need to be treated right away. Those that are very small (less than 3 mm) are less likely to break open.

Your doctor will help you decide whether it is safer to have surgery to block off the aneurysm before it can break open (rupture).

Someone may be too ill to have surgery, or it may be too dangerous to treat the aneurysm because of its location.

Treatment may involve:

  • Complete bedrest and activity restrictions
  • Drugs to prevent seizures
  • Medicines to control headaches and blood pressure

Once the aneurysm is repaired, prevention of stroke from blood vessel spasm may be necessary. This may include intravenous fluids, certain medications, and letting the blood pressure get high.

Expectations (prognosis):

The outcome varies. Patients who are in deep comas after an aneurysm rupture generally do not do as well as those with less severe symptoms.

Ruptured cerebral aneurysms are often deadly. About 25% of people die within 1 day, and another 25% die within about 3 months. Of those who survive, about 25% will have some sort of permanent disability.

Complications:

  • Increased pressure inside the skull
  • Loss of movement in one or more parts of the body
  • Loss of sensation of any part of the face or body
  • Seizures
  • Stroke
  • Subarachnoid hemorrhage

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if you have a sudden or severe headache, especially if you also have nausea, vomiting, seizures, or any other neurological symptoms.

Also call if you have a headache that is unusual for you, especially if it is severe or your worst headache ever.

  • Reviewed last on: 9/28/2010
  • Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital; and David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Bederson JB, Connolly ES Jr, Batjer HH, Dacey RG, Dion JE, Diringer MN, Duldner JE Jr, Harbaugh RE, Patel AB, Rosenwasser RH: 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.

Meyers PM, Schumacher HC, Higashida RT, Barnwell SL, Creager MA, Gupta R, McDougall CG, Pandey DK, Sacks D, Wechsler JR: American Heart Association. Indications for the performance of intracranial endovascular neurointerventional procedures: a scientific statement from the American Heart Associatino 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.

Patterson JT, Hanbali F, Franklin RL, Nauta HJW. Neurosurgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 72.

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