      |
|
Cerebral Aneurysm
The decision to treat an unruptured aneurysm depends on a number of factors, including the type, location and size of the aneurysm, your age, and your general health. Most unruptured aneurysms less than 7 millimeters across — about the size of a pencil eraser appear to pose risk of rupture of approximately 0.5% per year, whereas the risk of treating aneurysms may be significant. Many are best left untreated. If you have a large aneurysm that hasn't burst, especially if it's pressing against brain tissue and causing signs and symptoms, such as headaches or impaired vision, you're more likely to need treatment.
Treatment options for ruptured and unruptured brain aneurysms include:
- Microvascular clipping. This surgical procedure is performed with general anesthesia. The neurosurgeon removes a section of your skull to access the aneurysm. and locates the blood vessel that feeds the aneurysm. Then he or she places a tiny metal clip on the neck of the aneurysm to stop blood flow to it.
- Endovascular embolization. This is a less invasive alternative to surgical clipping. You're given general anesthesia or sedation. The doctor then inserts a hollow plastic tube (catheter) into an artery, usually in your groin, and threads it through your body to the aneurysm. He or she then uses a guide wire to push a spiral of soft platinum wire through the catheter and into the aneurysm. The wire coils up inside the aneurysm, blocking the blood flow and causing the blood to clot.
Both procedures pose risks. The endovascular coil is less invasive and has a quicker recovery time, but it also has a higher risk of re-bleeding, so additional procedures may be necessary. The surgical clip procedure may be a better choice for people who have larger or more-complicated aneurysms.
Other treatments for ruptured brain aneurysms are aimed at relieving signs and symptoms. They may include:
- Medications. Anticonvulsant medications can prevent seizures, analgesics may relieve headache symptoms, and calcium channel blockers can help widen narrowed blood vessels.
- Shunt surgery. If you develop hydrocephalus, you may need to have surgery to insert a shunt system to carry excess cerebrospinal fluid out of your brain. This system, which consists of a flexible silicone rubber tube (shunt) and a valve, creates a drainage channel that starts in your brain and ends in your abdominal cavity
|  | |
|
|
