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Brain Aneurysm |
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Brain Aneurysm
 Signs and Symptoms
Diagnosis
Treatment
Treatment Almost all brain aneurysms need to be treated. If the aneurysm has already ruptured, the ultimate goal of treatment is to prevent another rupture and future bleeding while preserving the artery from which the aneurysm originated. If the aneurysm has not yet ruptured, the goal is to prevent it from doing so.
After a ruptured aneurysm is diagnosed, the aneurysm is secured as quickly as possible using a variety of surgical or endovascular coiling techniques.
Surgery
- Microsurgical Clipping -- The majority of aneurysms can be successfully treated using a surgical technique called microsurgical clipping. Aneurysms are located in the area outside the brain, called the subarachnoid spaces and fissures. During microsurgical clipping, the aneurysms are accessed by carefully opening these areas under the high magnification of operating microscopes. The surgeon then spreads the brain tissue apart and places small metal clips at the base of the aneurysm at the point where it arises from the artery, while maintaining this artery so that a stroke does not occur. After clipping the aneurysm, the bone is secured in its original place, and the wound is closed.
- Skull Base Surgery -- This surgery is typically used for deep and complex aneurysms, which are accessed through the bone at the base of the skull.
- Vascular Bypass Grafting -- Some aneurysms, such as those that are complex and very large, require vascular bypass grafting. During this procedure, a vein is taken from the leg and hooked up between an artery in the neck and an artery in the brain.
- 3-D Computer Modeling -- This novel technique, first performed by neurosurgeons at UCSF, is used for difficult to treat and rare aneurysms. It produces 3-D images of the aneurysm and blood flowing through the arteries to the aneurysm. First, dye is injected into patient arteries to track blood flow. A computer superimposes that information over brain scans to compose a 3-D model of the aneurysm. Then, on the computer, surgeons can test whether different surgical techniques would alter blood flow enough to ease hot spots of pressure inside the aneurysm.
- Endovascular Therapy -- A fairly new and minimally invasive alternative to surgery is endovascular treatment of brain aneurysms, known as endovascular coiling. The procedure does not require making an incision in the head, is performed under general anesthesia or light sedation, and has a shorter recovery time and hospital stay compared to conventional surgery. However, it is important to note that endovascular therapy is not recommended for all patients.
The procedure involves placing small, metal coils inside the aneurysm using a catheter -- a long, flexible tube. The catheter is inserted into the femoral artery in your leg and navigated through the vascular system, into the head and aneurysm. Tiny metal coils are threaded through the catheter and placed in the aneurysm, blocking blood flow into the aneurysm and preventing rupture. The coils are made of platinum so that they can be visible on an X-ray and are flexible enough to conform to the aneurysm shape.
Reviewed by health care specialists at UCSF Medical Center.
Last updated May 8, 2007
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