Open surgery to place a clip across a brain aneurysm and stop it from bleeding.

Overview

A brain aneurysm is a swelling or bulge in a blood vessel in the brain. Most brain aneurysms do not cause symptoms or problems. However, if an aneurysm bursts, it can cause bleeding around the brain (a haemorrhagic stroke), which is a serious medical emergency.

What causes a brain aneurysm?

The exact cause is not always known, but risk factors include:

• High blood pressure
• Smoking
• Family history of aneurysms
• Older age
• Heavy alcohol use
• Head injury or certain inherited medical conditions that weaken the blood vessel

Symptoms of a brain aneurysm

Small aneurysms may not cause symptoms. A larger or leaking aneurysm may cause:

• Severe headache
• Blurred or double vision
• Pain above or behind the eye
• Weakness or numbness
• Difficulty speaking
• Loss of balance

A burst aneurysm often causes a sudden, extremely severe headache.

How is a brain aneurysm diagnosed?

Tests may include:

CT (Computed Tomography) scan: Uses X-rays and a computer to create detailed pictures of the brain

• MRI (Magnetic Resonance Imaging) scan: Uses magnets and radio waves to produce detailed images of the brain and blood vessels

• CT angiography or MR angiography: Special scans using dye (contrast) to show blood vessels clearly and help detect aneurysms

• Cerebral angiogram: A detailed test where a thin tube (catheter) is inserted into a blood vessel and dye is injected to get clear images of blood vessels in the brain

What is the treatment for brain aneurysm?

Small brain aneurysms that are not causing symptoms may only need regular scans to monitor them.If there is a risk of rupture (bursting), or if the aneurysm has already burst, treatment may be needed.

Main treatment options include:

• Surgical clipping – a small metal clip is placed on the aneurysm to stop blood flow into it

• Endovascular coiling – tiny coils or a mesh tube are placed inside the aneurysm to reduce blood flow and help seal it

What is aneurysm clipping?

Aneurysm clipping is an operation to prevent an aneurysm from bursting or repair a ruptured aneurysm. A small metal clip is placed across the base of the aneurysm to stop blood flowing into it. This helps prevent the aneurysm from bleeding or bleeding again.

Procedure details

Before surgery:

• Blood pressure, pulse and temperature will be checked
• Blood tests and scans may be performed
• Tell your doctor about medicines and allergies
• You may need to stop eating and drinking for several hours before surgery

Step-by-step procedure overview

• You will receive general anaesthesia (you will be asleep)
• A small part of the scalp is shaved
• The surgeon makes an opening in the skull (craniotomy)
• The aneurysm is carefully located
• A tiny metal clip is placed at the base (neck) of the aneurysm
• Blood flow to the aneurysm stops
• The bone flap is placed back and secured with small metal plates and screws
• The wound is closed with stitches and covered with bandages
• The procedure may take up to 5 hours

Recovery after aneurysm clipping

• Hospital stay is usually 2–5 days after planned surgery, but may be 7–14 days if the aneurysm had ruptured• Full recovery often takes 6–8 weeks. Some people may feel tired for up to 6 months after surgery for a ruptured aneurysm

After the procedure

After surgery:

• You will be monitored closely in hospital
• Pain medicines will be given if needed
• You may feel tired or have headaches
• The healthcare team will check your neurological recovery

At home after surgery

You may be advised to:

• Get plenty of rest
• Avoid heavy lifting
• Take medicines as prescribed
• Attend follow-up appointments
• Avoid smoking and alcohol

Benefits and risks of aneurysm clipping

• Surgical clipping is usually very effective and treated aneurysms rarely return
• Risks include bleeding in the brain or reduced blood flow to the brain, but these risks are low
• Some people may face problems with movement, sensation, seizures or other changes in the ability to think

Warning signs (Red flags)

Seek urgent medical help if you notice:

• Sudden severe headache
• Weakness or numbness
• Difficulty speaking
• Fever
• Confusion
• Seizures
• Problems with vision

Lifestyle changes and long-term care

• Stop smoking if you smoke• Keep your blood pressure under control• Eat a healthy balanced diet• Exercise regularly• Maintain a healthy weight• Avoid excessive alcohol• Do not use illegal drugs

Myths & Facts

Frequently Asked Questions