The ultimate goal of brain aneurysm treatment is to prevent any future bleeding while preserving the artery from which the aneurysm originates. Currently, there are two major treatments:
The placement of a metal clip across the base of the expanded, balloon-like aneurysm is the most definitive treatment, and the success rate is excellent. Over the last 20 years, surgical techniques for repairing brain aneurysms have improved tremendously, and "microsurgical clipping" can be carried out with very little risk.
Some aneurysms however, cannot be safely clipped and require more sophisticated surgical techniques such as vascular bypass grafting, whereby a vein is taken from the leg and hooked up between an artery in the neck and an artery in the brain.
Very rarely, the patient's heart has to be stopped and the body cooled down in order to treat an aneurysm safely.
Endovascular treatment of brain aneurysms is an alternative to microsurgical clipping. During the procedure, a small tube is placed through an artery in the groin. The tube is advanced up to the arteries in the neck. Another smaller tube is threaded through the first one. Small platinum coils are delivered to the aneurysm through the second tube. They block off the ballooned part of the artery. and cause the aneurysms to clot and solidify, preventing further bleeding. The normal opening of the artery is left clear.
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The most important complication after an aneurysm has burst is the chance of it bleeding even more and not re-sealing itself. This is most common within the first 24 hours of the subarachnoid hemorrhage and the danger remains fairly high for another two weeks. It's generally recommended to treat the aneurysm early after it has caused a subarachnoid hemorrhage.
Once an aneurysm bursts and causes a subarachnoid hemorrhage, about one out of eight patients will die before receiving any medical attention. One-half of patients die within one month after the aneurysm bursts, and of those who do survive, less than one in three will be able to live normal lives.
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