Brain Aneurysm Surgery

• Physical examination: The doctor will check the symptoms of the patient to diagnose a brain aneurysm.

• CT scan and MRI scan: These are imaging tests done to obtain clear images of the brain and check if you have bleeding in the brain.

• MRI angiography: It is a type of MRI that is used to assess the arteries in detail to detect the presence of a brain aneurysm.

• Cerebrospinal fluid test: In case the patient has symptoms of a ruptured aneurysm which is not visible on the CT scan, the surgeon draws cerebrospinal fluid (the fluid surrounding the brain and spine) from the back using a needle to check for the presence of red blood cells, which may indicate a hemorrhage. This procedure of drawing cerebrospinal fluid is known as a spinal tap or lumbar puncture.

• Cerebral angiogram or cerebral arteriogram: The doctor will insert a catheter (a thin, flexible tube) into an artery usually in the groin area, and guide it past the heart into the brain arteries. A dye is then injected into the catheter, which travels to the arteries in the brain. A series of x-rays are then taken to detect an aneurysm.
  

A brain aneurysm can be corrected using the following surgical procedures:
1. Clipping:
The surgeon makes an incision into the scalp.
A hole is created in the skull.
A small metal clip is then placed at the base of the aneurysm to prevent the rupture of the aneurysm.
The skull is then closed and the scalp is stitched (sutures).

2. Endovascular repair:
The surgeon makes a small incision in the groin area. 
A catheter is then guided through the incision leading to the brain aneurysm.
The surgeon inserts a thin metal (platinum) wire into the aneurysm through the catheter tube, using a guide wire.
The platinum wire coils into a ball and initiates the formation of a blood clot.
This blood clot prevents the rupture of the brain aneurysm and also seals off the brain aneurysm from the artery.

The potential complications of brain aneurysm surgery are:

• Infection

• Bleeding

• Blood clot formation

• Allergic reaction to the anesthetic used

• Behavior changes

• Lack of co-ordination

• Nerve injury

• Brain swelling

• Confusion

• Seizures

• Speech problems

• Vision problems

• Weakness

• Stroke (a condition in which the blood supply to the brain is stopped)
  

• If there was no bleeding in the brain prior to the surgery, the patient may stay in the hospital for a few days after the procedure.
• The hospital stay may last for one or two weeks if there were complications before the procedure.
• The doctor may repeat CT scans or MRI scans in the follow-up appointments to ensure there are no complications.
• The patient will be prescribed medications to reduce the swelling for many weeks.
• In case of seizures during the hospital stay, the patient may be prescribed anticonvulsant medications for a long time.
• Pain medications may be prescribed in case of a persistent headache.
• Various therapies like physiotherapy, occupational therapy, speech therapy, swallowing therapy, and cognitive therapy may be required after the surgery.
• Lifestyle changes, as recommended by the doctor, should be followed.
• Complete recovery may take many months, especially if there is brain damage due to an aneurysm rupture.
• The patient may have some permanent damage to the brain, especially if an aneurysm ruptures before the surgery.