Who performs brain aneurysm repair?

The following specialists perform brain aneurysm repair:

  • Neurosurgeons specialize in the surgical care of diseases of the brain and nervous system. 
  • Neuroradiologists are doctors who specialize in diagnosing and treating diseases of the brain and nervous system using radiological imaging.
  • Pediatric neurosurgeons specialize in the surgical care of children with diseases and conditions of the brain and nervous system.

How is a brain aneurysm repair performed?

Your brain aneurysm repair will be performed in a hospital. 

Surgical approaches to a brain aneurysm repair

A brain aneurysm repair may be performed using one of the following approaches:

  • Minimally invasive surgery or endovascular coiling surgery involves inserting a catheter (tube) and guide wire through an artery in your groin or leg. Your doctor feeds or guides the catheter guide wire to your cerebral aneurysm. The catheter tip has detachable metal coils that are inserted in the aneurysm once the catheter is in place. The coils cause the aneurysm to clot off and prevent it from rupturing. Endovascular surgery generally involves a faster recovery and less pain than open surgery. It may be a good option if you are not a candidate for open surgery. Not all aneurysms can be repaired with this procedure. 
  • Open surgery or clipping involves making an incision in your scalp and removing a piece of your skull. Your surgeon will place a small metal clip around the base of your cerebral aneurysm to stop blood from flowing into it. Your surgeon will reattach the piece of your skull once the procedure is complete. Open surgery allows your doctor to directly view and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery involves more cutting and displacement of tissues and organs than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.

Your doctor will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different brain aneurysm repair procedures and ask why your doctor will use a certain procedure for you.

Types of anesthesia that may be used

Your doctor will perform brain aneurysm repair using either general anesthesia or regional anesthesia, depending on the specific procedure. 

  • General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the surgery and do not feel any pain. You may also receive a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control pain during and after surgery.
  • Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. To numb a smaller area, your doctor injects the anesthetic in the skin and tissues around the procedure area (local anesthesia). You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.

What to expect the day of your brain aneurysm repair

The day of your surgery, you can generally expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.
  • Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will have.
  • A surgical team member will start an IV.
  • The anesthesiologist or nurse anesthetist will start your anesthesia.
  • A tube will be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.
  • The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.