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United Hospital

Brain aneurysm

A program of:


Brain aneurysm treatment at United Hospital

United Hospital offers comprehensive and exceptional care for patients with brain aneurysms. Aneurysms are serious medical problems, requiring the expertise of specialists—from neurosurgeons and critical care nurses to rehabilitation specialists.

Learn more about brain aneurysms and vascular malformations.

Our approach

Our multidisciplinary approach leverages the expertise of world-class neurovascular specialists who collaborate to provide the best individualized care for each patient. Our comprehensive physician team includes neurosurgeons, interventional neuroradiologists, neurologists, psychologists and neurointensivists.

Leading United's brain aneurysm program is vascular neurosurgeon Eric Nussbaum, MD, medical director of United's neurovascular neurosurgery program. Dr. Nussbaum is among a small group of surgeons worldwide who specialize in brain aneurysm surgeries. He performs more than 350 brain surgeries a year and has performed more than 2,000 of the complex surgeries to treat aneurysms.

Neurological Intensive Care Unit

United's new Bentson Family Foundation Neurological Intensive Care Unit provides care for aneurysm patients after surgery and interventional radiology procedures. Directing care in the Neuro ICU are intensive care doctors who specialize in treating neurological patients.

Directions: United Hospital Lobby to the Neuro ICU (Unit 4400)


Source: Brain Aneurysms and Vascular Malformations
Reviewed by: Eric Nussbaum, MD, medical director of United's neurovascular neurosurgery program
First Published: 09/17/2013
Last Reviewed: 09/17/2013

Vascular malformations

Specialists in brain aneurysms at United Hospital also care for patients with vascular malformations.

Vascular malformations are abnormal connections between the arteries and veins in the brain. They are also called arteriovenous malformations (AVMs). These usually form before birth.

AVMs are located within the brain. Without the normal channels of vessels to handle blood under high pressure, AVMs can bleed. The bleeding causes a blood clot in the brain, which can lead to death or disability.

Although not as dangerous or common as brain aneurysms, AVMs have significant risks.

arteriovenous malformations (AVMs)

An arteriovenous malformation (AVM) is an abnormal connection between arteries and veins. Blood flows too quickly from the arteries and pushes on the walls of the veins. This can damage or weaken the veins and cause them to bulge and get twisted. If they burst, blood will leak into surrounding tissue, and may cause a stroke. People who have AVMs are usually born with this condition. The exact cause is not known.

Learn more

United Hospital offers exceptional care for patients with brain aneurysms and vascular malformations. United's comprehensive team of specialist physicians is led by Eric Nussbaum, MD, a neurosurgeon who specializes in aneurysm surgery. Dr. Nussbaum's patients have far lower complication rates than the national average for this type of surgery.

What is a brain aneurysm?
Location in the brain
Unruptured aneurysms

Symptoms

Brain aneurysms usually have no symptoms until they bleed. Symptoms of a ruptured aneurysm may include:

  • Severe, sudden headache, described as "the worst headache of my life"
  • Neck stiffness
  • Sensitivity to light
  • Nausea and vomiting
  • Loss of consciousness
  • Seizures

Most people with brain aneurysms realize that something is wrong and go to a hospital emergency room.

Why aneurysms are dangerous

Aneurysms that bleed are very serious: half of patients die before reaching a hospital or within the first few days. Of the patients who survive a ruptured aneurysm, half develop a serious disability.

A ruptured brain aneurysm requires treatment because it is likely to bleed again. Each time a brain aneurysm bleeds, the risk of death or disability is high.

Common problems

The possibility of these medical problems reinforces the need for prompt treatment after a ruptured aneurysm.

Hydrocephalus
Vasospasm
Electrolyte imbalance
Seizures
Pulmonary and cardiac issues

Source: Brain Aneurysms and Vascular Malformations, Allina Health's Patient Education Department
Reviewed by: Eric Nussbaum, MD, medical director of United's neurovascular neurosurgery program
First Published: 09/17/2013
Last Reviewed: 09/17/2013

The John Nasseff Neuroscience Institute at United Hospital offers exceptional care for patients with brain aneurysms and vascular malformations. United's multidisciplinary team of specialists has the experience and expertise to provide the highest quality of care at every step, from a patient's diagnosis and treatment to rehabilitation. In total, the team has completed over 4,000 aneurysm procedures.

Vascular neurosurgeon

Eric Nussbaum, MD, is a board-certified neurosurgeon who has significant experience in diagnosis and treatment of brain aneurysms and vascular malformations. He leads the neurovascular neurosurgery program at United Hospital. Dr. Nussbaum specializes in surgeries to repair brain aneurysms.

Dr. Nussbaum is among a small group of surgeons worldwide who specialize in brain aneurysm surgeries. He performs more than 350 brain surgeries a year and has performed more than 2,000 of the complex surgeries to treat aneurysms.

Nurse practitioners
Neuroradiologists
Neuro-intensive care physicians
Neurologists
Physiatrists (physical medicine and rehabilitation doctors)

Source: Brain Aneurysms and Vascular Malformations
Reviewed by: Eric Nussbaum, MD, medical director of United's neurovascular neurosurgery program
First Published: 09/17/2013
Last Reviewed: 09/17/2013

Tests in the hospital will show whether a person has an aneurysm and its location. Usually patients need a combination of tests to provide information for diagnosis and treatment. All of these procedures are performed at United Hospital.

CT (computed tomography) scan
MRI
Cerebral angiogram
MRA and CTA
Lumbar puncture

Source: Brain Aneurysms and Vascular Malformations
Reviewed by: Eric Nussbaum, MD, medical director of United's neurovascular neurosurgery program
First Published: 09/17/2013
Last Reviewed: 09/17/2013

The purpose of treatment is preventing a ruptured aneurysm from bleeding again. (For a patient with an unruptured aneurysm, observation alone may be appropriate.)

United Hospital's treatment team of neurosurgeons and neuroradiologists has the experience to recommend and perform treatment for each patient's unique needs. A number of factors, including the patient's medical condition and age, must be considered carefully in choosing the appropriate treatment. There are two main procedures to treat brain aneurysms.

Surgery to clip the aneurysm

The patient undergoes general anesthesia in the operating room. The neurosurgeon makes an incision to open the skull, then gently lifts the brain to reach the arteries below it.

Using an operating microscope, the neurosurgeon finds the aneurysm and closes it off with a small metal clip. This prevents the aneurysm from filling with blood and bleeding again.

Complications

Infection, bleeding during or after surgery which would create a stroke, permanent or transient brain injury or death. Risks of general anesthesia that are present in any surgery also apply. (Complication rates vary with the location of the aneurysm.)

Advantage

If surgery goes well, it permanently repairs the aneurysm, and the patient should not need further treatment.

Disadvantage

The risks of open surgery on the brain.

Endovascular coiling

Patients undergo general anesthesia for this procedure, which takes place in a radiology suite. It's performed by a neuroradiologist, a doctor who specializes in radiology interventions of the brain, spine and nerves.

A neuroradiologist inserts a long, narrow catheter to an artery in your groin and guides it to the aneurysm in your brain. The doctor threads small coils through the catheter into the aneurysm. These coils fill the aneurysm and help to prevent it from bleeding again.

Complications

Risk of stroke and rupture of the aneurysm during the procedure.

Advantage

Coiling avoids open surgery on the brain. It may be the best choice for elderly patients and those in poor condition from the aneurysm rupture.

Disadvantage

Some coiled aneurysms grow back.


Source: Brain Aneurysms and Vascular Malformations, Allina Health's Patient Education Department
Reviewed by: Eric Nussbaum, MD, medical director of United's neurovascular neurosurgery program
First Published: 09/17/2013
Last Reviewed: 09/17/2013

Courage Kenny Rehabilitation Institute™

Patients who receive treatment for ruptured brain aneurysms often need rehabilitation to regain their skills and reach their goals. Rehabilitation begins during the patient's stay at United Hospital, with staff from Courage Kenny Rehabilitation Institute, part of Allina Health.

Rehabilitation staff

The Institute's staff work with patients in the Bentson Family Foundation Neurological Intensive Care Unit and inpatient units.

The doctor who directs rehabilitation care is a physiatrist, a specialist in physical medicine and rehabilitation. The physiatrist evaluates each patient's physical and mental functioning, mood and motivation, and orders specific types of therapy. The doctor also checks for medication interaction issues and coordinates the timely start for therapy, including providing information to insurance for pre-authorization of therapy.

Physical and occupational therapists, speech-language pathologists and social workers help patients in the Bentson Family Foundation Neurological Intensive Care Unit and in hospital units.

Inpatient unit for rehabilitation

Courage Kenny Rehabilitation Institute's acute inpatient unit at United - 8940 is a comfortable environment where each patient receives care and practices daily living activities. The unit has earned accreditation from the Commission on the Accreditation of Rehabilitation Facilities (CARF). This means it meets the highest industry standards for quality care and service.

Outpatient rehabilitation services

After leaving the hospital, patients may receive ongoing therapies - including physical, occupational and speech therapy - at one of Courage Kenny Rehabilitation Institute's outpatient sites in Minnesota and western Wisconsin. These sites offer a full spectrum of services to improve patients' quality of life and help them achieve their personal best.

Source: Brain Aneurysms and Vascular Malformations
Reviewed by: Eric Nussbaum, MD, medical director of United's neurovascular neurosurgery program
First Published: 09/17/2013
Last Reviewed: 09/17/2013