Brain Aneurysm Repair


Sarah Lewis, PharmD

What is brain aneurysm repair?

Brain aneurysm repair is surgery to fix a cerebral (brain) aneurysm. An aneurysm is a weakened area in a blood vessel wall that widens and bulges. Over time, this weakened area can grow, stretch, balloon outward, and possibly rupture (burst). There is a significant risk of death associated with a ruptured cerebral aneurysm. Brain aneurysm repair is a treatment for cerebral aneurysms aimed at preventing rupture and hemorrhaging or bleeding into the brain.

Brain aneurysm repair is a major surgery with significant risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having a having brain aneurysm repair.

Types of brain aneurysm repair

The types of brain aneurysm repair procedures include:

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  • Clipping involves placing a small, metal clip around the base of your cerebral aneurysm. This prevents it from bursting or rupturing. Your doctor must remove part of your skull in order to place the clip. After the clipping, your doctor will reattach the piece of skull. Doctors also use this surgery in an emergency after a cerebral aneurysm has burst.

  • Endovascular coil embolization, or coiling, involves inserting a catheter into a blood vessel in your groin or arm. Your doctor feeds or guides the catheter wire to the area in the brain where the aneurysm is located. Your doctor uses X-rays to help guide the catheter to the correct position. Once in position, your doctor inserts tiny metal coils inside your aneurysm. This causes the aneurysm to clot off and prevents rupture.

Other procedures that may be performed

Your doctor may perform other procedures in addition to brain aneurysm repair. These include:

  • Occlusion involves clamping or occluding the artery that leads to your cerebral aneurysm. This procedure is usually done when an aneurysm has damaged the artery.

  • Bypass involves using a blood vessel taken from somewhere else in your body to create a new route around a damaged cerebral artery. A bypass is usually done along with an occlusion.

Why is brain aneurysm repair performed? 

Brain aneurysm repair is a major surgical procedure that your doctor may recommend to treat a cerebral aneurysm. An aneurysm is a weakened area in a blood vessel wall that widens and bulges. Over time, this weakened area can grow, stretch, and balloon outward. Aneurysms are serious health conditions because they can burst and cause life-threatening bleeding.

Not all cerebral aneurysms need to be treated. Small aneurysms are less likely to burst and may only require frequent monitoring and imaging. 

Your doctor will evaluate many factors when considering brain aneurysm repair. These include the size and location of your aneurysm, the presence or absence of symptoms, your age and medical conditions, and the presence or absence of other risk factors for aneurysm rupture.

Your doctor may only recommend brain aneurysm repair if other treatment options with less risk of complications have failed. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on brain aneurysm repair.

Your doctor may recommend brain aneurysm repair if your aneurysm is:

  • Causing symptoms. Most cerebral aneurysms do not have any symptoms. When they occur, symptoms of a cerebral aneurysm may include headache, double vision, eye pain, weakness, numbness, and dizziness. If you are having symptoms, it may be a sign that your cerebral aneurysm is about to burst. This is a medical emergency.

  • Large or growing rapidly. Cerebral aneurysms that are greater than 10 millimeters (less than four-tenths of an inch) in diameter have a greater risk of rupturing.

  • Located in the back part of your brain. This particular location has an increased risk of rupturing.

  • Leaking blood into the layers of the walls of your blood vessel. This is called a dissection.

  • Ruptured or burst. A ruptured cerebral aneurysm is a medical emergency. Symptoms that your cerebral aneurysm has ruptured or burst include severe headache, stiff neck, nausea, vomiting, sensitivity to light (photophobia), dilated pupils, drowsiness, and loss of consciousness.

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