Intracranial Aneurysm Surgery is done to treat patients with a bulging blood vessel in their brain that is at the risk of rupturing or tearing open. An aneurysm occurs when the wall of a blood vessel becomes thin and bulges or balloons out. Mostly aneurysms remain undetected because they often have no symptoms until they get ruptured. This surgery is highly important for the people with aneurysm in their brain, as this may lead to stroke or brain damage.
Some symptoms that arise after the aneurysm has ruptured are as follows:
- Severe headache
- Drooping eyelid
- Severe neck pain
- Impaired speech
- Double vision
- Numbness in the body
- Muscle weakness
Surgeons use several methods depending on the size of aneurysm
- Endovascular repair
What is a Brain Aneurysm?
An aneurysm is an abnormal, weak spot on a blood vessel that causes an outward bulging or ballooning of the arterial wall. These weak spots can involve all walls of the blood vessel (fusiform aneurysm), form a sac from one wall (saccular) or separate the vessel walls (dissecting). An aneurysm can affect any vessel in the body but only those in the head can cause a serious medical condition, a hemorrhagic stroke when they rupture, which can lead to brain damage and death. Brain aneurysms are often discovered when they rupture, causing bleeding into the brain or the space closely surrounding the brain called the subarachnoid space, causing a subarachnoid hemorrhage. Subarachnoid hemorrhage from a ruptured brain aneurysm can lead to a hemorrhagic stroke, brain damage and death. An aneurysm varies in size from 1/8 inch to approximately 1 inch. Aneurysms which are bigger than 1 inch are known as giant aneurysm and are very hard to treat.
What are the symptoms of Brain Aneurysm
Ruptured Cerebral Aneurysm Symptoms
When an aneurysm ruptures, called subarachnoid hemorrhage, people often complain of “the worst headache of their life.” Other ruptured cerebral aneurysm symptoms include:
- Nausea and vomiting
- Stiff neck or neck pain
- Blurred vision or double vision
- Pain above and behind the eye
- Dilated pupils
- Sensitivity to light
- Loss of sensation
- Unruptured Cerebral Aneurysm Symptoms
Most aneurysms are asymptomatic, particularly ones that are small. Occasionally, large aneurysms may cause the following symptoms related to pressure on the adjacent brain or nerves:
- Peripheral vision deficits
- Thinking or processing problems
- Speech complications
- Perceptual problems
- Sudden changes in behavior
- Loss of balance and coordination
- Decreased concentration
- Short-term memory difficulty
- Causes of Brain Aneurysm
Brain aneurysms can affect anyone, but people with atherosclerosis (hardening of the arteries) are at high risk of forming brain aneurysms. Women over the age of 40 are at an increased risk as well. Other people at risk for brain aneurysms are those who:
- abuse drugs
- have high blood pressure
- have congenital problems that affect the arterial walls
- have had abnormal growths in the head or body (tumors)
- have brain injuries
- have had severe infections of the blood or brain
- have high LDL cholesterol
- have a family history of aneurysms
Diagnosis of Brain Aneurysm
A brain aneurysm is usually diagnosed using a magnetic resonance imaging (MRI) scan and angiography (MRA), or a computerised tomography (CT) scan and angiography (CTA).
An MRI scan is usually used to look for aneurysms in the brain that haven’t ruptured. This type of scan uses strong magnetic fields and radio waves to produce detailed images of your brain.
A CT scan is usually preferred if it’s thought the aneurysm has ruptured and there’s bleeding on the brain (subarachnoid haemorrhage).
- This type of scan takes a series of X-rays, which are then assembled by a computer into a detailed three-dimensional image.
- In some cases, a ruptured aneurysm is not picked up by a CT scan. If a CT scan is negative but your symptoms strongly suggest you have a ruptured aneurysm, a test called a lumbar puncture will usually be carried out.
- A lumbar puncture is a procedure where a needle is inserted into the lower part of the spine to remove a sample of the fluid (cerebrospinal fluid) that surrounds and supports the brain and spinal cord. This fluid can be analysed for signs of bleeding.
Treatment of Brain Aneurysm
Not all aneurysms need to be treated and your physician may elect to closely observe your aneurysm. There are two main treatment options for patients who need to have their aneurysm treated.
Open surgical clipping
Endovascular therapy: coiling
Open surgical “clipping”:
The “open surgical clipping” is performed by a neurosurgeon who will make an incision in the skin over the head, make an opening in the bone and dissect through the spaces of the brain to place a clip across the aneurysm where it arises from the blood vessel. This prevents the blood flow from entering the aneurysm. Most elective patients spend 2-3 nights in the hospital and then will go home on light restricted activity for 1-2 months after surgery.
In this surgery A catheter is inserted into a vessel over the hip and other catheters are navigated through the blood vessels to the vessels of the brain and into the aneurysm. Coils are then packed into the aneurysm up to the point where it arises from the blood vessel, preventing blood flow from entering the aneurysm. Most elective patients will go home the next day after surgery and are back to normal activities the following day.
Cost of Intracranial Aneurysm Surgery
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