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Neurointerventional Surgery

Brain Aneurysm

Procedures

What is a Cerebral/Brain Aneurysm?


Aneurysms are treated via 2 major methods. The first, open neurosurgical clipping, is performed by a vascular neurosurgeon who specializes in open brain surgery. A small clip is placed on the neck of the aneurysm to close and exclude it from the normal arteries. The second, endovascular embolization, is performed by a neurointerventional surgeon who specializes in catheter-based minimally invasive treatments. While our team specializes in the latter, we work together with open vascular neurosurgeons to provide patients with a complete multidisciplinary team composed of dedicated experts in their respective fields. Embolization devices include coils, stents and a new device known as the WEB (Woven EndoBridge) device.

What are the Symptoms of a Cerebral Aneurysm?


The most characteristic manifestation of a cerebral aneurysm is a sudden onset severe headache - often described as a ‘thunderclap’ headache. Depending on the severity of bleeding, patient presentation to the hospital may range from headache alone to accompanying drowsiness, associated focal neurologic deficits, or a comatose state. Large aneurysms may present with gradual (or occasionally acute), progressive neurologic deficits related to pressure on surrounding nerves and other brain structures.

How is a Cerebral Aneurysm Diagnosed?


Ruptured aneurysms are typically discovered when a patient presents to the emergency department with SAH detected on a CT scan, with a special type of CT scan then performed to look at the blood vessels, called a CTA (CT angiography). Unruptured aneurysms are typically asymptomatic, but detected on brain MRI or CT imaging for other reasons. A diagnostic catheter angiogram is often then performed to characterize the aneurysm anatomy in fine detail in order to determine the best means of treatment.

How is a Cerebral Aneurysm Treated?


Aneurysms are treated via 2 major methods. The first, open neurosurgical clipping, is performed by a vascular neurosurgeon who specializes in open brain surgery. A small clip is placed on the neck of the aneurysm to close and exclude it from the normal arteries. The second, endovascular embolization, is performed by a neuroendovascular surgeon who specializes in catheter-based minimally invasive treatments. While our team specializes in the latter, we work together with open vascular neurosurgeons to provide patients with a complete multidisciplinary team composed of dedicated experts in their respective fields. Embolization devices include coils, stents, and a new device known as the WEB (Woven EndoBridge).