Brain Aneurysm Treatment

An aneurysm is a weak area in a blood vessel wall that usually enlarges and balloons out. A brain (cerebral) aneurysm or intracranial aneurysm (IA) is the ballooning or bulge on the wall of an artery in the brain. The pressure of blood flow in the weak walls of the ballooned area can lead to rupture of the brain aneurysm. This can result in a subarachnoid haemorrhage (SAH), or blood leakage into the area surrounding the brain – which may develop into an intracranial hematoma (a blood clot within the brain).

Brain aneurysm can occur due to congenital defects or other conditions such as high blood pressure, atherosclerosis (the build-up of fatty deposits in the arteries), or other causes. Cerebral aneurysms are common in adults over 40 years, smokers and hypertensives. They are slightly more common in women than in men.

Symptoms of brain aneurysm demanding treatment are:
  • Cranial nerve palsy
  • Dilated pupils or Double vision
  • Pain above and behind eye
  • Localized headache or Stiff neck
  • Nausea or Vomiting
  • Loss of sensation or Sensitivity to Light (photophobia)
Rupture of a cerebral aneurysm usually results in bleeding in the brain (SAH). Early brain aneurysm treatment reduces risk of:
  • Re-bleeding
  • Second haemorrhage which could be fatal or cause severe neurological deficits
  • Vasospasm which occurs in 1/3 of patients after 3-5 days that decreases blood supply to the brain and makes aneurysm coiling / surgical treatment impossible.

Brain Aneurysm Treatment Methods

After analyzing the symptoms and conducting various tests, one of the two types of brain aneurysm treatment methods such as Clipping and Aneurysm Coiling may be administered on the patients.

Clipping

Clipping is a surgical approach that requires a craniotomy. Craniotomy is a surgical procedure in which a section of the skull cap or bone plate is removed so that the surgeon can access the brain aneurysm. A tiny metal device like a paper clip is placed across the neck to stop blood flow into the aneurysm, and to prevent re-bleeding and further damage. After clipping the aneurysm, the bone plate is wired back into place and the wound is closed. This surgical approach requires the patient to be placed under general anesthesia, and hospitalization following the surgery.


Aneurysm Coiling

This is a non-surgical procedure using detachable Platinum Coils in the endovascular treatment of intracranial brain aneurysms. Platinum coils are used to occlude (fill) intracranial aneurysms, to significantly reduce the incidence of aneurysm rupture or re-rupture.

The coil is attached to a delivery wire and fed through a microcatheter into the aneurysm. The delivery wire allows the physician to properly position the coil within the aneurysm. Once positioned, the coil is detached from the delivery wire using an electrolytic detachment process.

“Coiling” packs the aneurysm tightly to close off blood flow into the aneurysm, thereby preventing its rupture. The number of coils used depends on the size of the aneurysm.

Additional Methods of Aneurysm Coiling Treatment

  • Blocking the artery from which the aneurysm arises using coils – parent artery occlusuion.
  • Balloon assisted or stent assisted coiling when the neck of the aneurysm is wide – to get adequate packing and prevent migration of coils.
  • Flow diverter placement – Specialised stents that act as internal bypass and prevent the aneurysm from filling.

Before

After

This is a non surgical procedure and is carried out by an interventional radiologist. The procedure is performed from the leg artery using small catheters and wires. Dr. Saurabh Joshi, the chief consultant and an Interventional Radiologist at the Vein Center, Mumbai, is experienced in such super specialty procedures of Brain Aneurysm treatments. Hospitalization time varies from 1 or 2 days to 10-14 days depending on the haemorrhage history of the patient.

Besides complex brain aneurysm treatment and highly skilled procedures like aneurysm coiling, the Vein Center, Mumbai, provides endovascular management of various diseases on day care basis also


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