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How is a Brain Aneurysm Treated?

If you have been diagnosed with a brain aneurysm, UI Health's team of experts at the Brain Aneurysm Center will assess all available options to develop the best treatment plan for you.

Individual factors that can affect brain aneurysm treatment decisions include:

If the aneurysm is unruptured, options for management may include the following:

  • Observation with follow-up imaging at regular time periods to monitor changes in
    the size of the aneurysm.
  • Aneurysm treatment with either surgical clipping or endovascular coiling.

Brain aneurysms can be treated either surgically or through an endovascular approach — about 50 percent of the aneurysms treated through an endovascular procedure, without the need for direct surgery.    

TREATMENT OPTIONS

Open Neurosurgery Craniotomy with Surgical Clipping Procedure 

A craniotomy is a surgical operation in which an incision is made into the bone of the skull to locate and clip the blood vessel with the aneurysm.

  • With the assistance of a microscope, the neurosurgeon locates the aneurysm and places a titanium clip to block off the aneurysm.
  • Most aneurysm clips used at present are MRI compatible.
  • Often, several clips may be required.
  • Angiography is done post-operatively to determine effectiveness of clipping.
  • The typical hospital stay for craniotomy and aneurysm clipping is between two and three days. 
  • Most aneurysms can be treated through a minimally invasive approach with a small eyebrow or hairline incision and silver dollar size opening in the skull.

Craniotomy with Cerebral Bypass Procedure

UI Health is among only a handful of medical centers that perform cerebral bypass. Cerebral bypass is performed for complex aneurysms that can't be treated by traditional clipping.

  • Through a craniotomy, a bypass is placed to re-route the brain circulation around the aneurysm to prevent it from filling.
  • Intra-operative flow measurement, in addition to postoperative angiogram and NOVA MRA, are used to confirm bypass patency.
  • The typical hospital stay following cerebral bypass is between three and five days.

Endovascular Embolization Procedure

Aneurysm embolization is a nonsurgical treatment that is performed by a neuro-interventional specialist.

  • Under general anesthesia, a small catheter is threaded through the femoral (thigh) artery in the groin up into the brain.
  • The catheter is carefully guided to the aneurysm, and tiny platinum coils are guided through a microcatheter into the aneurysm to block it off.
  • Flow-diverting stents are a newer technology in use to treat aneurysms nonsurgically.
  • Hospital stay following an aneurysm embolization is between two and three days.