Brain & Nervous System Health Center

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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 brain aneurysms:

• 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.