Aneurysms Clipping or Coiling or Stenting

A brain aneurysm is the ballooning of a weak area on the artery wall or thinning of the blood vessel walls. This may compress and damage surrounding brain tissue. It can also rupture, causing blood to collect in the surrounding tissues. This haemorrhage can damage brain tissue and increase pressure inside the skull, disrupting oxygen supply to the brain.

Aneurysms can be caused by many factors, including high blood pressure, ageing, family history, head injury and hardened blood vessels. They can lead to complications such as unconsciousness and stroke. In severe cases, they can result in death.

Symptoms

Non-ruptured brain aneurysms usually have no symptoms. Sometimes they produce pain near the eye, visual impairment, a drooping eyelid, or weakness, numbness or paralysis on one side of the face. The main symptom of a ruptured aneurysm is a sudden, severe headache. Other symptoms may include nausea and vomiting, a stiff neck, confusion, blurred vision, fainting and seizures.

Diagnosis and Treatment Options

Aneurysms are diagnosed with magnetic resonance imaging (MRI) scans that include the use of gadolinium and performing a cerebral angiography. This enables specialists to view a 3-Dimensional image of the aneurysm. Aneurysms can either be coiled or clipped depending on its size, location and structure.

Treatment depends on the size and location of the aneurysm. Small aneurysms are usually monitored closely. Medication can relieve symptoms, manage pain and prevent complications such as seizures, stroke or narrowing of blood vessels.

There are two surgical procedures to treat ruptured or large aneurysms:

• Microvascular clipping involves using a metal clip on the neck of the aneurysm to block blood flow and prevent bleeding. If the artery is damaged, it may be clamped and the aneurysm bypassed with a vessel graft. This involves cutting through the skull.

• Endovascular embolization (Coiling) is a minimally invasive procedure where a catheter is inserted through the groin, reaching the aneurysm using x-ray imaging. Metallic coils are inserted through the catheter and released to clot the blood, block and destroy the aneurysm.

Recovery

Recovery time for patients with an unruptured aneurysm is usually shorter than for patients who have had emergency treatment for a ruptured aneurysm. Recovery can differ from patient to patient.