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Brain Aneurysm Repair

Brain Aneurysm Repair

A brain aneurysm repair is surgery to fix a cerebral (brain) aneurysm. An aneurysm is a weakened area in a blood vessel wall that widens and bulges. Over time, this weakened area can grow, stretch, balloon outward, and possibly rupture (burst). There is a significant risk of death associated with a ruptured cerebral aneurysm. A Brain Surgery and aneurysm repair is a treatment for cerebral aneurysms aimed at preventing rupture and haemorrhaging or bleeding into the brain.The types of brain aneurysm repair procedures include:

Clipping is a procedure in which your doctor places a small, metal clip around the base of your cerebral aneurysm. This prevents it from bursting or rupturing. Your doctor must remove part of your skull in order to place the clip. After the clipping, your doctor will reattach the piece of skull. Doctors also use this procedure as an emergency procedure after a cerebral aneurysm has burst.

Endovascular coil embolization, or coiling, is a procedure in which your doctor inserts a catheter into a blood vessel in your groin or arm. He or she feeds or guides the catheter wire to the area of the brain where the aneurysm is located. Your doctor uses X-rays to help guide the catheter to the correct position. Once in position, your doctor inserts tiny metal coils inside your aneurysm. This causes the aneurysm to clot off and prevents rupture.

 

What is a Brain Aneurysm Repair?

A Brain aneurysm repair is a relatively common but major surgery with significant risks and potential complications. You may have less invasive treatment options available depending on your specific circumstances. You should consider getting a second opinion about all your treatment choices before having a brain aneurysm repair.

 

Types of Brain Aneurysm Repair

The types of brain aneurysm repair procedures include:

  • Clipping is a procedure in which your doctor places a small, metal clip around the base of your cerebral aneurysm. This prevents it from bursting or rupturing. Your doctor must remove part of your skull in order to place the clip. After the clipping, your doctor will reattach the piece of skull. Doctors also use this procedure as an emergency procedure after a cerebral aneurysm has burst.
  • Endovascular coil embolization, or coiling, is a procedure in which your doctor inserts a catheter into a blood vessel in your groin or arm. He or she feeds or guides the catheter wire to the area of the brain where the aneurysm is located. Your doctor uses X-rays to help guide the catheter to the correct position. Once in position, your doctor inserts tiny metal coils inside your aneurysm. This causes the aneurysm to clot off and prevents rupture.

Other Procedures That May Be Performed

In addition to a brain aneurysm repair, your doctor may also perform one or more other procedures. These include:

Occlusion involves clamping or occluding the artery that leads to your cerebral aneurysm. This procedure is usually done when an aneurysm has damaged the artery.

Bypass involves using a blood vessel taken from somewhere else in your body to create a new route around a damaged cerebral artery. A bypass is usually done along with an occlusion.

 

Why is a brain aneurysm repair performed?

A Brain aneurysm repair is a major surgical procedure that your doctor may recommend to treat a cerebral aneurysm. An aneurysm is a weakened area in a blood vessel wall that widens and bulges. Over time, this weakened area can grow, stretch, and balloon outward. Aneurysms are serious health conditions because they can burst and cause life-threatening bleeding.

Not all cerebral aneurysms need to be treated. Small aneurysms are less likely to burst and may only require frequent monitoring. Your doctor will evaluate many factors when considering brain aneurysm repair. These include the size and location of your aneurysm, the presence or absence of symptoms, your age and medical conditions, and the presence or absence of other risk factors for aneurysm rupture.

Your doctor may only recommend a brain aneurysm repair if other treatment options with less risk of complications have failed. Talk with your doctor about all of your treatment options and consider getting a second opinion.

 

Your Doctor May Recommend a Brain Aneurysm Repair if Your Aneurysm is:

Causing symptoms. Most cerebral aneurysms do not have any symptoms. When they occur, symptoms of a cerebral aneurysm may include a headache, double vision, eye pain, weakness, numbness, and dizziness. If you are having symptoms, it may be a sign that your cerebral aneurysm is about to burst. This is a medical emergency.

Large or growing rapidly. Cerebral aneurysms that are greater than 10 millimeters (less than four-tenths of an inch) in diameter have a greater risk of rupturing.

Located in the back part of your brain. This particular location has an increased risk of rupturing.

Leaking blood into the layers of the walls of your blood vessel. This is called a dissection.

Ruptured or burst. A ruptured cerebral aneurysm is a medical emergency. Symptoms that your cerebral aneurysm has ruptured or burst include a severe headache, stiff neck, nausea, vomiting, and sensitivity to light (photophobia), dilated pupils, drowsiness, and loss of consciousness.

How do I Prepare for My Brain Aneurysm Repair?

You are a very important member of your own healthcare team. The steps you take before surgery can improve your outcome after the procedure. You can best prepare yourself for a brain aneurysm repair by:

  • Answering all questions about your medical history and medications you take. This includes prescribed medications, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
  • Getting pre-operative testing as directed. Testing varies depending on your age, health, and specific procedure. Pre-operative testing may include blood tests and other tests as needed.
  • If you are overweight, talk to your doctor about losing weight before the surgery through a healthy diet and exercise plan.
  • Not eating or drinking just prior to surgery as directed. Your doctor may cancel your surgery if you eat or drink too close to the start of the procedure due to a risk of complications. These include choking on stomach contents during deep anesthesia.
  • Stopping smoking as soon as possible. Even quitting for a just few days can be helpful.
  • Taking or stopping medications exactly as directed. For a brain aneurysm repair, this may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.

 

Questions to Ask Your Doctor

Facing surgery can be stressful. It is common for patients to forget some of their questions during a brief doctor’s office visit. You may also think of other questions after your appointment. You should contact your doctor and make sure your questions are answered before the procedure. It is also a good idea to bring a list of questions and a friend or family member to your pre-operative appointments. Questions can include:

  • Why do I need a brain aneurysm repair? Are there any other options for treating my condition?
  • Which type of procedure do I need?
  • How long will the surgery take? When will I be able to go home?
  • What restrictions will I have after the surgery? When can I expect to return to work and other activities?
  • What kind of assistance will I need at home?
  • What medications will I need before and after the surgery?
  • How will you manage my pain?
  • How should I contact you? When should I see you in follow-up? Ask for numbers to call during and after regular hours.

What Can I Expect After my Brain Aneurysm Repair?

Knowing what to expect can help make your road to recovery after a brain aneurysm repair as smooth as possible.

How Long Will it Take to Recover?

After surgery, you will stay briefly in the recovery room until your vital signs are stable. Your care team will then move you to an intensive care unit (ICU). ICUs provide 24-hour monitoring and specialized care.

It may take a few hours until the major effects of anesthesia wear off and you are alert. When you wake up, you may have a breathing tube in your mouth and many tubes and wires attached to your body. These allow your team to monitor your vital signs, drain bodily fluids, take blood, and give medications and fluids. You will not be able to talk if you have a breathing tube. However, the care team usually removes it within a few days. As your recovery progresses, you may move to a hospital room outside the ICU.

A typical hospital stay for endovascular (minimally invasive) coiling surgery ranges from one to two days. If you have open surgery or clipping, you may stay in the hospital for four to six days.

Recovery after surgery is a gradual process. How long it will take for you to recover and return to normal activities varies depending on the specific procedure and type of anesthesia used, your general health, age, and other factors. Your doctor may refer you to a rehabilitation program to help you recover. Full recovery times range from a few weeks to a few months.

Will I Feel Pain?

Pain control is an important element to healing and a smooth recovery. Although there will be discomfort after your surgery, you can expect that your doctor and care team will manage your pain effectively so you are comfortable and can get the rest you need. Contact your doctor if you are in pain despite following your pain management plan or if your pain gets worse or changes.

When should I call my doctor?

After a brain aneurysm repair, you should keep your follow-up appointments. You should call your doctor if you have any concerns between appointments. Call your doctor in Spine Hospital in Gurgaon right away or seek immediate medical care if you have:

  • Bleeding
  • Change in level of consciousness or alertness, such as passing out, dizziness, unresponsiveness, or confusion
  • Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery and not necessarily a sign of a surgical infection. However, you should follow your doctor’s specific instructions about when to call for a fever.
  • Inability to urinate or have a bowel movement.
  • Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot.
  • Pain that is not controlled by your pain medication.
  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing or wheezing.
  • Unexpected drainage, pus, redness or swelling of your incision.

How Might a Brain Aneurysm Repair Affect My Everyday Life?

A/C to Dr. Arun Saroha – A brain aneurysm repair may cure your condition so you can lead an active, normal life. However, it can cause significant changes to your body that may affect your everyday life, such as the need to:

  • Have frequent follow-up visits and imaging tests to check the coil that was placed in endovascular coiling surgery.
  • Notify all of your healthcare providers about your brain aneurysm repair. You may not be able to have certain testing procedures such as MRI.
  • Treat other conditions including high blood pressure, high cholesterol, and diabetes.

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