Craniotomy and Clipping of Cerebral Aneurysm You are here:HomeOur ServicesList of ServicesNeuroscience - brain and spinalNeuroscience operationsCraniotomy and Clipping of Cerebral Aneurysm The options for treatment of a cerebral aneurysm include: Endovascular interventions ie coiling, stenting, glueing Operative intervention and clipping of the cerebral aneurysm Operation Craniotomy & clipping of cerebral aneurysm The neurosurgical treatment of an aneurysm involves the patient being put to sleep with a general anaesthetic. A curved incision and a bone window is created (craniotomy). A microscope is used to carefully identify the aneurysm and a permanent metallic clip is surgically placed across its neck, securing the aneurysm from further bleeding in the future. A ventricular drain may be inserted. Any associated blood clot is removed if safe and the bone is replaced with rivets and the patient awoken. If a subarachnoid haemorrhage has occurred often patients will require a two-week hospital stay ensuring a safe recovery. Intravascular treatment of cerebral aneurysm This procedure is performed by the neuroradiologist following discussion with the neurosurgeon. It is the essentially the same procedure as a digital subtraction angiogram however a general anaesthetic is required. A thin catheter and guidewire are passed upwards through the arteries to the base of the aneurysm. Several options are then possible including: Coiling Gluing Stenting The procedure will take several hours. Depending on what option is used you may be required to continue taking blood thinning medication like asprin or plavix for a period of time. The neuroradiologist will discuss this with you. Several monitoring angiograms will also be required following this procedure. Occasionally the aneurysm neck may reform requiring a second procedure or operation. Risks of these procedures The risks of this operation includes the following. A detailed discussion with your surgeon is recommended prior to surgery. Infection – superficial wound infection or deeper infections including meningitis, osteomyelitis Bleeding – which may be superficial or deep causing intracerebral haematoma and stroke-like symptoms such as weakness, numbness and speech disturbance Epilepsy which may require medication Permanent neurological damage in the form of weakness, numbness, paralysis (stroke like symptoms) Cognitive impairment,which may include subtle changes in personality, memory & thought processing. Hydrocephalus – which may be temporary or permanent and may require a second operation. Loss of vision or double vision. Loss of smell or cerebrospinal fluid leak through the nose if a frontal approach is required. The need for a blood transfusion during or after the procedure. Coma and death Treatment of a ruptured cerebral aneurysm usually occurs in a rapid manner due to the risk of the aneurysm rebleeding. In cases where the patient is in a poor grade SAH early intervention gives the best chance of any recovery. For more information on St Vincent's Neuroscience services and additional resources visit our dedicated Neuroscience site here.