National Brain Aneurysm Month- As soon as the name of brain aneurysm is heard, the first question that arises in the mind of the patient and family members is whether surgery will have to be done by opening the skull to get its treatment? According to experts this is not necessary. Some brain aneurysms can only be monitored through regular checkups, while others require treatment. The special thing is that even if treatment is required, open surgery is not the only option for every patient. In many suitable cases, treatment can also be done through the blood vessel route without opening the skull.
What is brain aneurysm?
According to Dr. Vipul Gupta, Director – Neurointerventional Surgery, Sir HN Reliance Foundation Hospital, Mumbai, brain aneurysm is the weakening of the wall of a blood vessel in the brain and bulging outward like a balloon. Small aneurysms often do not cause any symptoms or problems for a long time. Some aneurysms may be at risk of bursting over time, causing severe bleeding in the brain.
Therefore, after detection of aneurysm, the decision of surgery is not taken immediately. Its size, location, shape, and relationship to surrounding blood vessels, as well as the patient’s age and other health conditions, are taken into account.
Treatment can be done even without opening the skull
Today, many aneurysms can be treated with endovascular treatment in appropriate cases. In this, a thin catheter is inserted from a blood vessel in the wrist or thigh and is sent to the affected blood vessel of the brain. After this, the aneurysm is separated from the blood stream with the help of special equipment.
This procedure does not require opening the skull and therefore may be a less invasive treatment option in some patients. However, it is not necessary that this technique is suitable for every aneurysm.
Clipping is a better option in some cases
Open surgery i.e. surgical clipping plays an important role even today. In this procedure, the surgeon reaches directly to the aneurysm and places a small clip at its base, which stops the blood flow in it. The choice between endovascular treatment and clipping is decided based on the location of the aneurysm and the health conditions of the patient.
Treatment of every aneurysm is not necessary
In the case of unruptured brain aneurysm, an important question before doctors is whether to treat it now or keep it under observation. In some small and low-risk aneurysms, monitoring through regular scans may be sufficient. In aneurysms that are considered to have a higher risk of future rupture, preventive treatment may be recommended.
This decision is made by comparing the potential risks associated with treatment and the risk of the aneurysm rupturing in the future. Therefore, it is not necessary that the right decision for one patient applies to another patient.
Difference between ruptured and unruptured aneurysm
Bleeding in the brain after an aneurysm ruptures can be a serious and emergency condition. Treatment and recovery of such patients may differ significantly from planned treatment for unruptured aneurysms. The patient’s neurological status, severity of bleeding, treatment technique, and potential complications affect recovery.
Therefore, the diagnosis of a brain aneurysm is not in itself an indication for major surgery. Some patients may require only observation, while others may require endovascular treatment or surgical clipping. The right option is decided by the specialist after assessing the characteristics of the aneurysm and the overall health condition of the patient. The goal is to choose the safest and most appropriate treatment for the patient while minimizing the serious risk of aneurysm rupture.
Input By : Dr. Vipul Gupta, Director-Neurointerventional Surgery, Sir HN Reliance Foundation Hospital, Mumbai
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FAQ
Can brain aneurysm be completely cured without surgery?
If the aneurysm is very small, it can be treated without surgery and monitored only with medications (blood pressure control) and regular scans. At the same time, treatment without open surgery is possible with endovascular technique.
What is the first symptom when a brain aneurysm bursts?
The first symptom is a sudden, extremely severe headache, which the patient has never experienced in his life.
What is the difference between endovascular coiling and clipping?
In coiling, treatment is done by inserting a catheter through a vein in the leg or arm, whereas in clipping, the aneurysm is clipped by opening the skull.
What is the main cause of brain aneurysm?
High blood pressure, smoking, increasing age, weakness in nerves and genetic reasons are its main factors.
Can brain aneurysm patients live a normal life?
Yes, if proper treatment or monitoring is done on time, patients can become completely healthy and lead a normal life.