Brain Aneurysm Treatments & What to Expect


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Brain Aneurysm Treatments & What to Expect

Even though the risk of an unruptured aneurysm bleeding is relatively small, the consequences can be debilitating. More patients with unruptured aneurysms are choosing to seek out the best care - not just the closest care. Since the majority of people are unaware that they even have an aneurysm until it ruptures, immediate access to care is vital. Patients should be taken to the nearest hospital to ensure timely, critical care.

The sooner you understand your treatment options, the sooner we can act.

In the case of a non-emergency or elective surgery, we will clearly explain your treatment options and recommendations to you and your family. This consultation occurs one to two days prior to being admitted to the hospital. Some procedures will require preparation (e.g. no eating or drinking prior to surgery), while others require little to no planning.

In an emergency, you have limited options. If you experience symptoms of a ruptured aneurysm, CALL 911. We do not encourage you to have someone to drive you to the hospital. In an emergency vehicle the paramedics can execute lifesaving procedures if necessary. Our neurologists promptly meet with EMS upon your arrival.

The HealthEast Neurosurgery team has established critical care procedures to not only stop the bleeding and potential permanent damage to the brain, but to reduce the risk of recurrence and optimize the chance for a full recovery. With one of the few neurointensive care units (neuro ICUs) in the country, our physicians and nurses are dedicated to the goal of saving the brain, giving you the best chance at resuming your life.

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Neurosurgery Clinic hours: 7 am to 4:30 pm, Monday - Friday
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If you're seeking a second opinion, please give us a call. (Second opinions are not provided via online requests.) We will be happy to have one of our specialists contact you to discuss your request.

Treatments for ruptured and unruptured aneurysms

Once the status of your neurological condition has been evaluated, we will help you determine a treatment plan. The severity and location of your brain aneurysm will determine whether we advise observation or surgery.

Non-surgical treatment: observation

Observation is when no direct action is taken. Your surgeon considers it safer to monitor the unruptured aneurysm than it is to attempt other invasive procedures.

The neurologist or surgeon may suggest following-up with an MRA (magnetic resonance angiography used to detect suspected aneurysms) or a CTA scan (special x-ray used to detect a ruptured aneurysm) from six months to one year after the initial diagnosis to observe any changes in the aneurysm's growth.

Observation is rarely an option once the aneurysm has ruptured. There is a high risk of a ruptured aneurysm to re-bleed, so patients usually undergo surgical treatment. 

Surgical treatments

Surgical treatment procedures for aneurysms include clipping and coiling. Determining which of these options to pursue should be decided mutually between you and your physician.

Keeping in mind that aneurysm surgery carries potential risks, our team will make recommendations based on a complete evaluation of your condition.

  • Clipping

    The neurosurgeon opens the skull and delicately separates the aneurysm from the surrounding tissue. A small titanium clip, which opens and closes like a clothespin, is then placed across the base of the aneurysm.

    Once the clip is secured, blood can no longer flow in or out of the aneurysm sac. By using a needle to drain the remaining blood out of the aneurysm, the sac should empty and eventually collapse.

    When the blood flow is preserved through the main artery, the aneurysm is not likely to return. To ensure accuracy, an angiogram is performed, where a tiny camera takes an X-ray picture of the surgical area. This tells the surgeon that the aneurysm has been completely clipped without hitting any nerves or other arteries.
  • Coiling

    Also known as endovascular therapy, coiling is an innovative, less invasive surgical treatment option. This procedure does not involve craniotomy (the opening of the skull), and is performed from inside the blood vessel.

    A catheter is inserted into the patient's groin area and is guided up toward the brain. A fine wire is then threaded into the catheter and directed into the aneurysm. Once inside the aneurysm, the wire twists into small coils and continues filling the aneurysm sac until it eventually clots off. Approximately three-quarters of the ruptured aneurysms treated at HealthEast Neurosurgery are treated with endovascular surgery by Dr. Madison and his partners.

What to expect

It is common to feel anxious and uncertain before treatment. but our team of physicians will be on hand to meet with you and your family to address all concerns.

We are devoted to maintaining an environment of clear, consistent communication. We achieve this through our family care conferences and support groups, which encourage this continuous communication.

Our specialists ensure that all questions have been answered and that everyone understands all recommendations and procedures. We also provide emotional support before and after treatment.