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Brain aneurysm repair - Overview

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

Definition of Brain aneurysm repair:

Brain aneurysm repair is a surgical procedure to correct an aneurysm, a weak area in the wall of a blood vessel that causes the blood vessel to bulge or balloon out. It can leak blood and cause a stroke or bleeding into an area around the brain (also called a subarachnoid hemorrhage).

See also: Aneurysm in the brain

Description:

You and your doctor will decide the best way to perform surgery on your aneurysm. There are two common methods used to repair an aneurysm:

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

During aneurysm clipping:

  • You are given general anesthesia and a breathing tube.
  • Your scalp, skull, and the coverings of the brain are opened up.
  • A metal clip is placed at the base of the aneurysm to prevent it from breaking open (rupturing).

During endovascular repair of an aneurysm:

  • The procedure is usually done in the radiology section of the hospital.
  • You may have general anesthesia and a breathing tube. Or, you may be given medication to relax you, but not enough to put you to sleep.
  • A catheter is guided through a small cut in your groin to an artery and then to the small blood vessels in your brain where the aneurysm is.
  • Thin metal wires are put into the aneurysm. They then coil up into a mesh ball. Blood clots that form around this coil prevent the aneurysm from breaking open and bleeding.
  • During and right after this procedure, you may be given a blood thinner called heparin.

Why the Procedure Is Performed:

If an aneurysm in the brain ruptures, it is an emergency that needs medical treatment, and 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.

  • 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).
  • Reviewed last on: 8/27/2010
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

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.

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.

Patterson JT, Hanbali F, Franklin RL, Nauta HJW. Neurosurgey. 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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