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The options for treatment of a cerebral aneurysm include:
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.
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:
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.
The risks of this operation includes the following. A detailed discussion with your surgeon is recommended prior to surgery.
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.