A brain aneurysm is a bulge or ballooning in a blood vessel in the brain and often looks like a berry hanging on a stem. A brain aneurysm can leak or rupture and can cause bleeding into the brain (hemorrhagic stroke), and usually, a ruptured brain aneurysm occurs in the space between the brain and the thin tissues covering the brain and is called a subarachnoid hemorrhage. A ruptured aneurysm quickly becomes life-threatening and demands quick medical treatment.

Brain aneurysm surgery is done to correct an aneurysm, a weak area in a blood vessel wall that makes the vessel bulge or balloon out  and sometimes burst (rupture), bleeding into the cerebrospinal fluid (CSF) around the brain.

Potential risks of brain aneurysm repair include:

• behavior changes due to neurological injury.
• blood clots.
• brain swelling.
• confusion.
• infection.
• seizures.
• speech and vision problems.
• stroke.

The study found that short-term survival rates increased among patients who underwent the surgery to repair a ruptured abdominal aortic aneurysm, and the relative survival rate held steady at about 87 percent, and on average, patients who underwent repair for a ruptured aneurysm lived 5.4 years after surgery.

Yes, you can appear for the surgery to fix an aneurysm in your brain, preventing strokes, bleeding, and brain damage.

Without complications, a coiling procedure for an unruptured aneurysm typically takes between an hour and a half and three hours.

It will take three to six weeks to fully recover, but if you had bleeding from your aneurysm this may take longer, and you may feel tired for up to twelve or more weeks, and If you had a stroke or brain injury from the bleeding, you may have permanent problems such as muscle weakness, trouble with speech or thinking, or numbness.

If you had bleeding before, during, or after surgery you may have some short- or long-term problems which may be mild or severe, which for many people, these problems get better over time. You may feel sad, angry, or very nervous, which is normal. Have may have a seizure and will have to take medicine to prevent another one. You will have headaches that may continue for a while, which
is also common.

Brain aneurysm repair surgery in India can cost up to INR 3 lakh.

A ballooning or bulging of a blood vessel in the brain due to the weakening of the artery is known as a brain aneurysm.

A ruptured brain aneurysm or a brain aneurysm that is likely to rupture may need a surgical procedure to repair the brain aneurysm. This brain aneurysm repair procedure is known as brain aneurysm surgery.

The different types of brain aneurysms include:

1. Saccular aneurysm: This is a common type of brain aneurysm, which bulges out from the brain artery in a dome shape and is attached to the artery by a narrow neck.
2. Fusiform aneurysm: This type of aneurysm makes a widened spot in the brain artery.

The exact cause of a brain aneurysm is unknown. It occurs due to weakness in the brain artery, which is often seen at the junction where the artery forks or branches into different directions. This may happen due to:
The breakdown of the elastic tissue within the brain artery
Stress due to blood flow through the brain artery
Tissue changes seen in the brain artery due to inflammation

The following factors may increase the risk of developing brain aneurysm:

• Age above 40 years
• More common in women
• Family history
• High blood pressure
• Smoking
• Alcohol abuse
• Drug abuse
• Head injury
• Coarctation of the aorta (a congenital condition in which there is a narrowing of the aorta, which is the main artery of the heart)
• Arteriovenous malformations (congenital defect in the blood vessels of the circulatory system)
• Infections that damage the artery walls, causing mycotic aneurysms
• Genetic conditions like Marfan syndrome (inherited connective tissue disorder), Ehlers-Danlos syndrome (also an inherited condition affecting the connective tissues of the body), autosomal dominant polycystic kidney disease (a condition in which fluid-filled sacs or cysts grow in the kidney)

Small aneurysms normally do not cause any symptoms. When the brain aneurysm increases in size, it may press on the surrounding tissues and nerves to start producing symptoms.
The symptoms of an unruptured brain aneurysm are:

• Headache
• Pain above or behind the eye
• Numbness or weakness impacting one side of the face
• Double vision
• Blurred vision
• Dilation of a pupil
• The symptom of an aneurysm that leaks some blood into the brain is a sudden, severe headache. This is called a sentinel headache. This may occur days or weeks before the complete rupture of a brain aneurysm.
• The symptoms of a ruptured brain aneurysm are:
• Severe, sudden headache
• Stiffness of the neck
• Double vision
• Blurred vision
• Sensitivity to light
• Drooping eyelid
• Dizziness
• Difficulty in walking
• Trouble in communication
• Change in mental state or awareness
• Confusion
• Nausea
• Vomiting
• Seizures
• Loss of consciousness
• A ruptured brain aneurysm can cause life-threatening bleeding conditions and requires prompt medical treatment.

The complications associated with a brain aneurysm are:

• Risk of re-bleeding
• Loss of consciousness
• Vasospasm (when the blood vessels in the brain narrow erratically)
• Ischemic stroke (blood flow to the brain cells is interrupted)
• Subarachnoid hemorrhage (rupture of the aneurysm causing bleeding between the brain and its surrounding tissue)
• Hydrocephalus (increased pressure on the brain causing damage to the tissues)
• Hyponatremia (a drop in the sodium levels in the blood, resulting in swelling of the brain cells and permanent damage to the brain)

The doctor will first examine the patient physically and note down the symptoms of the patient, along with the patient’s medical and family history. The following diagnostic tests may be recommended to confirm the presence of a brain aneurysm:
Imaging tests: CT scans and MRI scans are imaging tests done to obtain clear images of the brain. They help in diagnosing the presence of an aneurysm.

1. Cerebrospinal fluid (CSF) tests: The cerebrospinal fluid (the fluid surrounding the brain and spinal cord) is obtained from the back using a needle. This procedure is known as a spinal tap or lumbar puncture. The presence of blood in the CSF may indicate bleeding in the brain.
2. Digital subtraction angiography: A thin, flexible tube known as a catheter is inserted into an artery in the groin region. This catheter is then threaded up to the brain. A special dye is then injected through the catheter and x-rays are taken to check the blood vessels, which become clearer due to the injected dye.

The following preparation may be required before undergoing a brain aneurysm surgery:
The doctor needs to be informed about any medical conditions that the patient may be suffering from.
The doctor will have to be informed if the patient is taking any medications, supplements, or herbs.
If the patient is sensitive or allergic to any medications, anesthetic agents, latex, iodine, or tape, the doctor needs to be informed before the procedure.
The patient is instructed to stop taking blood-thinners like warfarin and aspirin a few days before the procedure.
The patient should quit smoking at least two weeks before the procedure.
The patient is instructed to not eat or drink anything after midnight the day before the surgery.

The doctor may recommend certain medications to relieve the symptoms of a ruptured brain aneurysm. These medications may include:

Pain-relieving medications, to treat pain due to headache

Calcium channel blockers, to prevent vasospasm

Vasodilators, to expand the affected blood vessels

Vasopressor, which is given intravenously (injected directly into the vein) to increase the blood pressure and overcome the resistance of narrowed blood vessels

Anti-seizure medications to treat seizures

The different surgical procedures that can be performed to treat brain aneurysms include:

Surgical clipping:

It is a procedure performed to close off an aneurysm.

A section of the skull is removed by the surgeon.

The blood vessel that feeds the aneurysm is located.

A tiny metal clip is then placed on the neck of the aneurysm to stop any blood flow to it.

Endovascular coiling:

This procedure is less invasive than surgical clipping.

A hollow plastic tube (catheter) is inserted into the artery, usually in the groin region, and threads it through the body to the brain aneurysm.

A guidewire is then used to push a soft platinum wire through the catheter into the aneurysm.

The wire will could up inside the aneurysm to disrupt the blood flow and seal off the aneurysm from the artery.

After a brain aneurysm surgery,
The patient is likely to stay in the hospital for a few days after the procedure if there was no bleeding in the brain before the procedure.
The patient may stay in the hospital for one or two weeks in case of brain aneurysm complications before the procedure.
The doctor orders CT scans or MRI scans during the follow-up appointments to ensure that there is no aneurysm.
The doctor may prescribe medications to reduce the swelling, headache, and pain following the procedure.
If the patient suffers from seizures during the hospital stay, the doctor prescribes anticonvulsant medications that need to be taken for a long time.
Various therapies like physiotherapy, speech therapy, swallowing therapy, occupational therapy, and cognitive therapy may be recommended to the patient after the surgery.
Lifestyle changes, medications, and diet should be followed, as per the doctor’s instructions.
Complete recovery may take several months, especially in cases of an aneurysm rupture.
There may be some permanent damage to the brain, especially in cases of aneurysm rupture that has occurred before the surgery.

The side effects of a brain aneurysm surgery may include:

• Infection
• Bleeding
• Blood clot formation
• Allergic reaction to the anesthesia or due used
• Nerve injury
• Changes in behavior
• Confusion
• Lack of co-ordination
• Swelling of the brain
• Headache
• Seizures
• Vision problems
• Speech problems
• Fatigue
• Stroke 

The following lifestyle changes are recommended to prevent brain aneurysm, and if present, prevent the rupture of the aneurysm:

• Avoid alcohol consumption
• Quit smoking
• Limit the intake of caffeine
• Avoid drug abuse
• Eat a healthy diet
• Exercise regularly
• Avoid heavy lifting
• Keep your blood pressure under control