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When is Surgery Done on a Brain Aneurysm?

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Getting the news that you have a brain aneurysm can be scary. About 5 percent of people have this condition, in which a weak area of the blood vessel wall balloons out or bulges, according to MedlinePlus.

While only a small number of brain aneurysms cause symptoms or rupture, they can have serious effects. For example, a ruptured brain aneurysm can cause a severe headache, seizures, confusion and muscle weakness.

Surgery is done in cases in which the brain aneurysm has ruptured, as a ruptured brain aneurysm is a medical emergency. Two surgical options are available: aneurysm clipping and endovascular repair.

With aneurysm clipping, the goal is to close off the brain aneurysm. The procedure starts with a craniotomy, in which the surgeon gains access to the aneurysm by opening up the skull. Then the surgeon places a metal clip at the aneurysm’s neck to stop its blood flow.

The other option, endovascular repair or endovascular coiling, is a less invasive procedure. The incision is made by the patient’s groin, and the surgeon threads a catheter through an artery up the body to the brain aneurysm.

Once the catheter reaches the aneurysm, a thin wire is pushed through, which coils inside the brain aneurysm. Then, blood clots form around the coil, thus sealing off the brain aneurysm.

So if the brain aneurysm has not ruptured, will surgery be done?

It depends on the case. Surgery may be done to prevent a future rupture, though the MayoClinic.com noted that the risks of these surgical procedures may be greater than their benefit.

When deciding whether to perform surgery on an unruptured brain aneurysm, the physicians involved will weigh several factors, such as the patient’s health and the size of the brain aneurysm. For example, brain aneurysms that are smaller than 3 mm are less likely to rupture, according to MedlinePlus, so surgery may not be done right away.

However, if the patient has a family history of ruptured aneurysms or a congenital condition that increases her risk of a ruptured brain aneurysm, the decision of when to operate may change. Patients should talk to their doctors about the benefits and risks of surgery, and what type of intervention is best for them.


MayoClinic.com. Brain Aneurysm. Web. 16 February 2012

MedlinePlus Medical Encyclopedia. Aneurysm in the Brain. Web. 16 February 2012

Reviewed February 16, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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For more information please see the Brain Aneurysm Foundation (BAF) website: http://www.bafound.org

February 16, 2012 - 7:09pm
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