An aneurysm is an abnormality of the blood vessel where its lining becomes thin and if the pressure on its wall is much it may balloon out or stretch to form an abnormal shape. This thin vessel is more prone to rupture. It may also cause a stroke.
Brain aneurysm repair is a procedure used to restore the normal structure and function of the damaged artery. Smaller aneurysms and aneurysm toward the front of the brain are less expected to rupture. Size-wise, aneurysm smaller than 7 millimeters are considered less expected to rupture.
- Mostly asymptomatic unless ruptures –
- Eye pain
- Neck pain
- Ruptured aneurysm present as –
- Severe headache
- Drooping eyelid
- Abrupt speech
- Diplopia or double vision
- Numbness all through the body
- Muscular weakness
- Reduced level of alertness
There are other factors apart from the location that affects the approach to managing brain aneurysm repair:
- Age of patient with an aneurysm
- Medical history
- Dimensions of aneurysm
The risk involved with aneurysm repair:
- Behaviour changes
- Blood clots
- Swelling in the aneurysm area
- State of confusion
- Uncoordinated movements
- Temporary memory loss
- Speech and vision problems
Diagnosis of an aneurysm is done usually finding some other pathology in which the aneurysm is accidentally discovered:
- CT Scan
- CT Angiogram after injecting a dye
- Cerebrospinal fluid test for traces of red blood cells in CSF
- Cerebral Angiogram – A tube is inserted into the groin (femoral artery) reaching the patient’s brain colour-coded with a dye to show the vessel with an aneurysm.
Brain aneurysm repair takes place under general anesthesia. The patient is kept on overnight fasting and includes:
- Surgical clipping – A section of the skull is removed to reach the aneurysm. The neck of this aneurysm is then secured with the help of a metal clip.
- Endovascular Coiling – This is a minimally invasive procedure through a catheter from the groin up to the brain. A wire is then introduced from this catheter which coils up within the aneurysm creating a clot, cutting it off from the artery.
- Flow diverters – Tubular stent-like implants called flow diverters are used here to divert blood flow away from aneurysm providing it time to heal. It is comparatively a newer procedure recommended for a bigger aneurysm that is unmanageable by the above procedures.
A person is required to stay in the hospital for a couple of weeks.
Most importantly our main target should be to identify the real reason from which aneurysm has resulted. It could be blood pressure, diabetes, atherosclerosis, and more such giants. Addressing them medically and through lifestyle, medications will take you a long healthy way.
Dr. Ashish Shrivastava | HOD & Senior Consultant – Neurosurgery | Dharamshila Narayana Superspeciality Hospital, Delhi