Brain Aneurysm - Topic Overview
How is it treated?
Your doctor will consider several factors before
deciding the best treatment for you. Things that will determine the type of
treatment you receive include your age, size of the aneurysm, any additional
risk factors, and your overall health.
Because the risk of a
small (less than 10 mm) aneurysm rupturing is low and surgery for a brain
aneurysm is often risky, your doctor may want to continue to
observe your condition rather than perform surgery. If your aneurysm
is large or causing pain or other symptoms, though, or if you have had a previous
ruptured aneurysm, your doctor may recommend surgery.
The following surgeries are used to treat both ruptured and unruptured
- Coil embolization.
During this procedure, a small tube is inserted into the affected artery and
positioned near the aneurysm. Tiny metal coils are then moved through the tube
into the aneurysm, relieving pressure on the aneurysm and making it less likely
to rupture. This procedure is less invasive and is believed to be safer than
surgical clipping, although it may not be as effective at reducing the risk of
a later rupture. It should be done in a large hospital where many such
procedures are done.
- Surgical clipping. This surgery involves placing a small metal clip around the
base of the aneurysm to isolate it from normal blood circulation. This
decreases the pressure on the aneurysm and prevents it from rupturing. Whether
this surgery can be done depends on the location of the aneurysm, its size, and
your general health.
Some aneurysms bulge in such a way that the aneurysm has to
be cut out and the ends of the blood vessel stitched together, but this is very
rare. Sometimes the artery is not long enough to stitch together, and a
piece of another artery has to be used.
Aneurysms that have bled
are very serious and in many cases lead to death or disability. Management
includes hospitalization, intensive care to relieve pressure in the brain
and maintain breathing and vital functions (such as blood pressure), and
treatment to prevent rebleeding.