Treatment for brain aneurysms is more promising than it was several years ago. There are more effective and less- invasive treatment options for patients who in years past may have been told they had inoperable aneurysms. Doctors consider several factors when deciding which treatment option is best for a particular patient. Some factors include patient age, size of aneurysm and location of aneurysm.
Options for treatment are:
- Open surgery (The surgical method for treating an aneurysm. The surgeon exposes the aneurysm with a craniotomy and places a metal clip across the base of the aneurysm so that blood cannot enter it.)
- Within the blood vessels/vascular system. therapy (coils, stents, flow diversion device)
- No treatment: observation, with control of risk factors and possible repeat imaging
Decisions regarding treatment are based on many factors, including:
- The patient’s neurological condition, medical condition, and age
- The location, size, and shape of the aneurysm
- The availability of treatment options
- Whether the aneurysm is ruptured or unruptured
- The risk of aneurysm rupture
- Family history of aneurysm or subarachnoid hemorrhage
These and other factors help your doctor decide which type of treatment to recommend.
Usually doctors treat the aneurysm with the method that presents the lowest risk and highest chance for success. For example, aneurysms in the back part of the brain may be more safely treated with coils. Endovascular treatment may also be better for sick or older patients because it does not require long, deep anesthesia.
Open surgery may be better for healthy, young patients due to the known longevity of clipping. It may also be recommended for patients with aneurysms requiring treatment that are not safely treatable with an endovascular approach.
It is important to keep in mind that the primary goal of treatment is to prevent the aneurysm from bleeding or re-bleeding. Treatment does not usually improve symptoms except when large aneurysms are pressing on nerves.