Treatments

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.

Reviewed By: Eric Nussbaum, MD, medical director of United's neurovascular neurosurgery program
First Published: 09/17/2013
Last Reviewed: 09/17/2013