A brain aneurysm is a weak, balloon-like bulge on an artery in the brain. If it bursts, it causes a subarachnoid haemorrhage, which is a medical emergency. Treatment seals the aneurysm off from the blood flow, either by open surgery (clipping) or from inside the vessel (coiling). Often the choice is made together by the neurosurgeon and an interventional radiologist.
Who it may help
- An aneurysm found by chance on a scan
- A ruptured aneurysm causing sudden severe headache or collapse
- Repeated or growing aneurysms on follow-up scans
- A family history of aneurysms or of polycystic kidney disease, with a scan advised by a doctor
Conditions treated
- Saccular (berry) aneurysms
- Fusiform aneurysms
- Giant aneurysms
- Multiple aneurysms
- Aneurysms of the back (posterior) circulation
- Ruptured and unruptured aneurysms
Treatment options
- Microsurgical clipping Through a craniotomy, a small titanium clip is placed across the neck of the aneurysm so that blood no longer enters it.
- Endovascular coiling A catheter is passed from the groin or wrist up to the aneurysm and soft platinum coils fill it so that it clots.
- Stent-assisted coiling For aneurysms with a wide neck, a small mesh tube holds the coils in place.
- Flow diversion For some large or fusiform aneurysms, a special stent redirects blood away from the sac.
Before the procedure
- CT angiography or digital subtraction angiography (DSA)
- Heart and kidney checks
- Neurological examination and anaesthesia assessment
- A discussion of the options and the reasons for the chosen one
Recovery: what to expect
- Clipping: about 5 to 7 days in hospital, then roughly 2 weeks to feel settled at home.
- Coiling: often 2 to 3 days in hospital.
- Close monitoring in the intensive-care unit for the first 24 to 48 hours.
- After a rupture, rehabilitation may be needed for movement, speech or thinking.
- Follow-up imaging at about 6 weeks, 6 months and 1 year.
These are typical timings. Your own plan depends on your condition, your general health and the operation chosen, and Dr. Chakraborty will go through it with you.
Risks to know about
Every operation carries risk. The ones most relevant here are:
- Stroke, bleeding or swelling of the brain
- Blood clots forming on coils or stents, which is why blood thinners are needed with some treatments
- The aneurysm refilling after coiling, needing further treatment
- Problems at the groin or wrist puncture site
- After a rupture, the outcome depends largely on the severity of the first bleed
Your own risks depend on your health and your scans, and are explained in detail before you decide on anything.
Common questions
Is coiling always better than clipping?
No. Coiling is less invasive and suits many aneurysms, but clipping is more durable for others. The choice depends on the aneurysm and on you.
Can an aneurysm be left alone?
Some small, unruptured aneurysms are watched with regular scans. Others are treated to lower the risk of rupture. This is decided with your doctor.
Do I need follow-up after coiling?
Yes. Repeat imaging checks for any regrowth or settling of the coils.
What are the chances after a rupture?
It depends on how severe the bleed was and how quickly treatment starts. Early treatment improves the chance of recovery.
This page is general information to help you prepare for a consultation. It is not medical advice and does not replace an examination. Every plan is made for the individual patient.