What Should I Do If I Have An Unruptured Cerebral Aneurysm
If you have an unruptured brain aneurysm, its important to talk to your healthcare provider about your treatment and management options. You and your provider may decide its best to closely monitor it and manage medical conditions that can further weaken the blood vessel, or you may decide early treatment makes the most sense. Your healthcare provider will take into account several factors including the aneurysms:
- Risk of rupture.
No Brain Wave Activity After Aneurysm
What Is Endovascular Coiling
Endovascular coiling is a procedure performed to block blood flow into an aneurysm . Endovascular coiling is a more recent treatment for brain aneurysms it has been used in patients since 1991.
Endovascular coiling is a minimally invasive technique, which means an incision in the skull is not required to treat the brain aneurysm. Rather, a catheter is used to reach the aneurysm in the brain.
During endovascular coiling, a catheter is passed through the groin up into the artery containing the aneurysm. Platinum coils are then released. The coils induce clotting of the aneurysm and, in this way, prevent blood from getting into it.
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What Happens During An Endovascular Coiling Procedure
Patients are admitted to a hospital on the day of their procedure. Patients are not allowed to eat or drink on the day of the procedure. An IV is started to supply fluids. At the time of the procedure, the patient is taken to a special room in the radiology department some anesthesia or sedation is used to help the patient relax. A catheter, or long tube, is inserted into the femoral artery and carefully fed through the aorta into one of the arteries which goes into the brain. Dye is used to identify the aneurysm once the aneurysm is located, small wires are inserted into the aneurysm and coil into place. Additional wires are implanted in this way until the aneurysm is full. After the wires are completely inserted and the associated artery is checked with dye to confirm there is no injury, the catheter is removed. The area where the catheter had been inserted in the femoral artery is held firmly for several minutes to prevent bleeding.
After the procedure is completed, patients are observed for several hours. Following the procedure, patients may be allowed to go home the same day. However, if the procedure had been performed to treat an aneurysm that had leaked or ruptured, patients may be hospitalized for several days or weeks.
Recovering From A Coiling Procedure
After a coiling procedure, you can expect to spend a day or two in the hospital. Right after the procedure, you will need to lie flat for up to six hours with your leg extended. Without complications, your recovery at home can take about a week, with a gradual return to normal activities during that time.
You can expect to see your doctors for follow-ups to check the healing of your incision and the placement of the coils. In most cases, coiling resolves an aneurysm completely, but in some situations, the coils can become compacted, so that blood can start to fill the aneurysm again. In those cases, a second coiling might be needed to close off the aneurysm.
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What To Expect After An Aneurysm Diagnosis
I tell patients the most common location of an aneurysm is below the arteries that go to the kidneys, he says. An aneurysm is a disease that is normally caused by age as well as cigarette smoking, although occasionally family history plays a part.
An abdominal aortic aneurysm is the result of an artery above the pelvis and below the chest expanding or dilating to more than one and a half times its original size. Aneurysms usually grow slowly and are asymptomatic at first, which can make them hard to detect. Some aneurysms will never rupture.
Other risk factors for abdominal aortic aneurysm include:
- Atherosclerosis, or fatty and plaque accumulation that narrows the lining of the arterial walls
- Previous aneurysms
- Vasculitis, or inflammation of the blood vessels
Symptoms of an aneurysm usually do not present until it ruptures. If the aneurysm bursts, patients may experience:
- Sudden shooting pain in the abdomen or back
- Discomfort in the stomach area to the groin, buttocks, and lower limbs
- Dizziness and sweating
- Shock or fainting
How is an Aneurysm Treated?
Larger aneurysms may require surgical intervention.
Recovery After Aneurysm Surgery
What Can I Do To Reduce My Risk Of Having Another Brain Aneurysm
Taking care of your overall health is the best thing you can do to prevent future aneurysms. Steps you can take include:
- Eat a healthy diet, limit caffeine and avoid stimulant drugs.
- Quit smoking.
- Manage conditions that contribute to high blood pressure.
- Talk to your healthcare provider about lifestyle changes you can make and medications that may help.
A sudden, severe headache with or without stroke symptoms could be a sign of a brain aneurysm. A ruptured brain aneurysm is a serious, life-threatening condition that needs immediate medical attention and emergency treatment. If you have an unruptured brain aneurysm, talk with your healthcare provider about the risks and benefits of different treatment and management options.
Last reviewed by a Cleveland Clinic medical professional on 04/26/2020.
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What Causes Brain Aneurysms To Bleed
Researchers havent discovered exactly what causes an aneurysm to leak or rupture, which causes bleeding in or around the brain. But anything that increases your blood pressure can be dangerous. Higher blood pressure makes blood push harder against blood vessel walls. Things that may increase blood pressure include:
- Ongoing stress or a sudden burst of anger or other strong emotion.
- Working hard to lift, carry or push something heavy like weights or furniture.
- Known high blood pressure that is not treated appropriately with medications.
What Are The Chances Of Surviving A Brain Aneurysm
People can go their entire lives not knowing they have an unruptured brain aneurysm. As long as its intact, your odds are good. But there is a risk that the brain aneurysm will rupture, which depends on many factors, including aneurysm size, location and several others. If an aneurysm does rupture, it leaks blood into the space surrounding your brain and sometimes into the brain tissue itself, causing a hemorrhagic stroke.
A ruptured brain aneurysm requires emergency medical treatment. As more time passes with a ruptured aneurysm, the likelihood of death or disability increases. About 75% of people with a ruptured brain aneurysm survive longer than 24 hours. A quarter of the survivors, though, may have life-ending complications within six months.
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Recovering From Clipping Surgery
Without complications, clipping surgery usually requires a hospital stay of three to five days. At home, your recovery typically takes between three and six weeks. You can expect restrictions on activities such as driving, lifting and taking baths, but you can gradually resume normal activities during that period.
Recovering From A Pipeline Procedure
Like coiling, a pipeline procedure requires a day or so in the hospital. Right after the procedure, you must lie flat with your leg extended for a few hours. At home, your recovery typically takes a week or two, and you can expect to have follow -ups to check your incision and the placement of the PED.
Unruptured brain aneurysms can be treated by clipping, coiling or a pipeline procedure and your neurosurgeons will work with you to determine which treatment option is right for your unique circumstances.
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Aneurysm Coiling: Her Best Option
By mapping the blood vessels of Ms. Allen’s head and neck with a cerebral angiogram, Avi Setton, MD, NSUH’s chief of interventional neuroradiology, and David Chalif, MD, NSUH’s chief of vascular neurosurgery, discovered the location, size and shape of the ruptured brain aneurysm.
“We studied these results before deciding between clipping the aneurysm during open surgery or fixing it from the inside with endovascular coiling,” Dr. Setton said. “Stacy’s aneurysm sat in a high-risk area for surgery, making coiling a safer option.”
The minimally invasive, complex process can take up to four hours. After endovascular coiling, the patient usually remains hospitalized for up to 14 days in NSUH’s Neurosurgical Intensive Care Unit. The team manages medical issues that can often follow the original hemorrhage, such as widened ventricles and narrowed blood vessels.
Why Is This Procedure Done
A brain aneurysm, also called a cerebral aneurysm, is a weak spot along a blood vessel in the brain that bulges outward. Treatment of an aneurysm depends on factors including the size, location and shape of your aneurysm, whether or not it has ruptured, and your age and general health. Although some aneurysms may go undetected throughout life, these blood-filled sacs can enlarge, bleed or burst, causing stroke, neurological damage or even death. Coiling and stenting are among the ways to treat aneurysms.
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How Aneurysm Coiling Works
An aneurysm coil is a device inserted via catheter to fill in a brain aneurysm a bulge in a blood vessel. A coil can stop a ruptured aneurysm from continuing to bleed, or prevent an unruptured aneurysm from bleeding. A coil implantation system consists of a soft platinum coil soldered to a stainless steel delivery wire.
To treat an aneurysm, UPMC neurosurgeons:
- First places a microcatheter a long tube tipped with miniature instruments inside the aneurysm.
- Properly positions the catheter.
- Navigates a coil through the catheter and into the aneurysm.
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Recovery After Aortic Aneurysm Repair: What To Expect
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A Variable Recovery Process After Surgery
Following brain tumor surgery, patients are moved to an intensive care unit, where nurses and physicians carefully monitor brain function and vital signs while trying to ascertain any deficits or complications. In fact, patients might feel worse than they did before the surgery.
Brain surgery can cause swelling in the brain. The surgical team monitors this closely and gives treatment to reduce the swelling. But it might still cause symptoms such as:
What Is A Brain Aneurysm
An aneurysm is a damaged or weakened area in the wall of an artery that supplies blood to the brain. This weak area balloons out, creating a sac that fills with blood. Some aneurysms remain small and cause no symptoms, but an aneurysm can enlarge, putting pressure on the brain and causing symptoms such as headaches, double vision, or pain above and behind the eye.
Enlarged aneurysms can begin to bleed slowly, but more frequently an aneurysm unsuspectingly bursts an event called a subarachnoid hemorrhage, or stroke. While the majority of people with an aneurysm will never experience a burst, a ruptured aneurysm is a medical emergency, and prompt treatment can save lives and minimize long-term neurological problems.
Aneurysms can have a number of causes. Heredity may play a role, and so can atherosclerosis, or hardening of the arteries, and abnormalities at the junctions where blood vessels come together. Some are caused by infections of the artery wall. Although some aneurysms can be managed by taking care of an underlying condition with medication or lifestyle changes, your doctors may determine that either clipping surgery or a coiling procedure can offer the best option for resolving your aneurysm.
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How Are Aneurysm Coiling And Stenting Done
Endovascular embolization is a treatment in which a catheter is inserted into an artery in your groin or wrist and threaded through the body to the site of the brain aneurysm. Detachable metal coils are passed through the catheter and then released into the aneurysm. The coils fill the aneurysm, preventing blood from flowing through it and causing it to close off. This decreases the chances of rupture or other future complications. Aneurysm coil embolization can be performed in both ruptured and unruptured aneurysms.
Stents are small metal tubes that are used for certain kinds of aneurysms. Stents can be placed at the same time as coils in order to make sure the coils are positioned perfectly inside of the aneurysm. Stents are also placed through the same catheters used for coil embolization.
Embolization Device For Brain Aneurysms
An embolization device is an intricate stent that is made up of metal and other materials and carefully woven into a cylindrical shape.
The stents consist of 48 strands of a mix of metals, including platinum and chromium. The stents are designed with the precise amount and types of metals in order to effectively and safely treat aneurysms.
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Recovery From A Coiling Procedure
For some patients, your neurosurgeon will recommend you undergo a coiling procedure. Coiling is endovascular, meaning that the surgeon accesses the aneurysm by navigating through the blood vessels of your body. In this procedure, the surgeon will enter via your leg, rather than through the skull.
If you undergo coiling, you can expect your brain aneurysm recovery time to be slightly shorter, provided there are not complications and you are admitted in a non-emergency situation. You will typically only spend a day or two in the hospital for monitoring, but the first six to 24 hours of that will require you to lay flat on your back in your bed. Patients whose aneurysms have ruptured may spend in the range of three weeks in a hospital setting, depending upon the circumstances.
Once you are discharged, you can expect to spend from three to seven days under restrictions. Your doctor will give you specific instructions depending upon your situation, but you will likely be home from work for about a week, with instructions to avoid driving or lifting anything heavier than 10 pounds for three days and to be sure to drink plenty of water in order to flush out the dye from the procedure.
Within approximately a week, you will be able to resume all of your normal daily activities, as advised by your physician. You will likely take pain-reducing medications after your surgery, but your doctor may also recommend you take a blood-thinning prescription following your coiling procedure.
What Are The Risks Of Coiling
The levels of risk will very much depend on your own individual circumstances, including the size and location of the aneurysm in your brain, whether or not it has ruptured , your age and your overall health.
It is likely that the benefits of coiling will strongly outweigh any possible risks, and your doctor will have discussed this with you fully before you give your consent to go ahead with the procedure.
However, as with any invasive procedure, there are possible complications. These include stroke-like symptoms, such as weakness or numbness in an arm or leg and problems with speech or vision.
There is also a risk of bleeding, infection or damage to the artery at the place where the catheter goes into your groin.
Based upon the evidence available, doctors agree that coiling is a safe procedure.
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Each Patient Is Different
While these general guidelines hold true for many patients, the fact is that every patient is different. Your age, health status, size of your aneurysm, location of your aneurysm, medications and lifestyle may all affect your recovery time from any procedure. It is important to consult with your surgeon to decide which procedure is best for your condition.
While brain aneurysm surgery recovery time is an important consideration, it is incredibly variable and should not be the only factor when deciding whether or not to have surgery and, if so, which procedure is best for you. Both clipping and coiling are effective treatments for brain aneurysms, and an experienced neurosurgeon can help you determine which will likely have the best outcome for your particular situation.