Brain Aneurysm Surgery

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A brain aneurysm, also called a cerebral aneurysm or intracranial aneurysm, is a blister-like, weakened area in the wall of an artery in the brain. Because the artery wall is weakened where the aneurysm is, there is a risk that it will rupture. A ruptured aneurysm causes blood to bleed into the brain, known as a subarachnoid hemorrhage, a life-threatening event that requires emergency medical treatment with brain aneurysm surgery. When an artery bleeds into the brain, it may deprive brain cells and tissue of needed oxygen and also creates a buildup of pressure in surrounding tissues. This pressure causes swelling and irritation in the brain, leading to a wide range of brain aneurysm symptoms. Frequently, patients who have an aneurysm do not experience symptoms until the aneurysm ruptures.

Treatment for a brain aneurysm depends upon the patient's age and overall health, the extent of the condition, specific signs and symptoms, patient's tolerance for medications, and personal preferences. Approaches to brain aneurysm surgery include:

  • Aneurysm clipping uses a clip to isolate the aneurysm from normal circulation
  • Bypass surgery re-routes blood flow around the brain aneurysm; may be done for aneurysms with unusual structure
  • Advanced intraoperative imaging uses techniques such as indocyanine green videoangiography (imaging using green dye) during surgery to ensure that an aneurysm has been resolved and good blood flow is maintained in the surrounding blood vessels
  • Endovascular approaches are minimally invasive procedures performed through a blood vessel; includes coiling or stent coiling, which uses a catheter to insert wires inside an aneurysm to prevent it from rupturing

At Brigham and Women's Hospital, our highly trained specialists in the Department of Neurosurgery deliver state-of-the-art treatment through many innovative techniques to improve outcomes for patients undergoing brain aneurysm surgery.

Brain Aneurysm Endovascular Coiling Procedure:
This animation demonstrates a brain aneurysm treatment by inserting coils into the aneurysm both without and with the assistance of a stent to block the blood flow into the aneurysm, but still allow blood to flow in the regular blood vessels. This is a minimally invasive procedure in which a neurosurgeon/neuro-interventionalist will gain access to the vessels through the femoral artery. In the animation, the first brain aneurysm procedure is without a stent. The second procedure inserts coiling with the assistance of a stent. (This animation has no sound.)

 

Brain Aneurysm Flow Diversion Stent Procedure:
This animation demonstrates a flow diversion, which is one type of endovascular technique to treating brain aneurysms. This is a minimally invasive procedure in which catheters are inserted into the femoral artery and are brought all the way up into the vessels of the brain near the aneurysm. A flow diverting stent is laid across the neck or opening of the brain aneurysm. The stent slows blood flow into the aneurysm, causing it to clot off and shrink. Overtime, the body accumulates a layer of cells over the stent and it becomes a permanent part of the blood vessel. (This animation has no sound.)

Brigham and Women's Hospital: world-class neurosurgery services, including brain aneurysm surgery

At Brigham and Women's Hospital, patients with ruptured aneurysms are treated by our Boston neurosurgery specialists in the Neurosurgical Intensive Care Unit. Patients needing brain aneurysm surgery can generally be treated by minimally invasive microsurgical or endovascular approaches. A complete range of services, including endovascular treatment of blood vessel spasms (vasospasms) and transcranial Doppler, used to measure blood flow velocity in the brain, are available at all times. Our team provides timely, patient-centered care at our Boston campus as well as at our community locations, Brigham and Women's /Mass General Health Care Center in Foxborough, and our Ambulatory Care Center in Chestnut Hill

The Brigham and Women's Hospital Center for Cerebrovascular Diseases is a multidisciplinary program involving a team of neurosurgeons, interventional neuroradiologists, neurologists, and radiation specialists. We offer a complete spectrum of therapies, including the most effective state-of-the-art surgical and endovascular techniques for brain aneurysm surgery as well as advanced technologies for stroke treatment, brain cancer treatment, and treatment of a variety of cerebrovascular diseases.

Learn more about treatment of brain aneurysm symptoms, brain aneurysm surgery, and our expert Boston neurosurgeons at Brigham and Women's Hospital.

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