Aneurysm Clipping Surgery and Recovery

If you have a brain aneurysm that may rupture, you'll want to find an expert team skilled in aneurysm clipping. Clipping your aneurysm can reduce your risk of brain bleeding and stroke.

At UPMC, treating brain aneurysms with microsurgical clipping has had excellent durability and results.

The neurosurgical team uses many modern advancements for treating brain aneurysms, such as:

• High-tech microscopes.
• Live imaging of blood vessels.
• A broad array of clip configurations.

Advanced monitoring by the team allows them to detect and correct any damage before it becomes permanent. These advancements in aneurysm clipping have lead to improved patient outcomes at UPMC.

What Is an Aneurysm Clipping?

Aneurysm clipping is a type of brain surgery.

When a vessel in the brain forms a weak spot, it may fill with blood and bulge like a balloon. This bulging spot is a brain aneurysm (also known as a cerebral aneurysm).

Depending on its size and where the aneurysm forms, these weak spots can be dangerous. They may break open (rupture) and allow blood to leak into the brain.

Bleeding in the brain can cause:

• Brain damage.
• A hemorrhagic stroke.
• Death.

Neurosurgeons can clip brain aneurysms to ensure they don't rupture.

They apply a small metal clip that stops blood from flowing into the area. Without a blood supply, the aneurysm is no longer at risk of breaking open and shrinks over time.

When Would Someone Need Aneurysm Clipping?

UPMC neurosurgeons use aneurysm clipping when an aneurysm could burst or already has. If you have a ruptured aneurysm, you need treatment right away because brain bleeding may cause a stroke.

Not every aneurysm will burst.

But your surgeon may suggest clipping if you have an aneurysm that is:

• Growing.
• Large (bigger than a dime) or giant (larger than a quarter.
• In a large blood vessel with a higher risk of rupture.

What are the risks of a ruptured aneurysm?

Certain risk factors increase your chances of having an aneurysm burst, such as:

• Being a current smoker or having a history of smoking.
• Having high blood pressure.
• A family history of a ruptured aneurysm.

Your neurologist may order imaging tests to learn more about the size and location of a brain aneurysm.

Tests you may need include:

• CT scan. This shows the brain and skull from different angles.
• CT angiogram. This uses contrast dye and a CT scan to help doctors see how blood flows in your brain.
• MRI. This scan uses a computer and magnets to create detailed images of brain arteries.
• Cerebrospinal fluid (SCF) analysis. This test finds blood in the cerebrospinal fluid to see if there may be bleeding in the brain.

Who Should Have Aneurysm Clipping?

Clipping is safe and effective for many people. But it isn't right for everyone.

Your doctor will talk with you about the benefits and risks of aneurysm clipping.

Many aneurysms are treatable with clipping, and most don't come back after it.

When deciding whether to use clipping, surgeons look at the aneurysm's:

• Location in the brain.
• Shape.
• Size.

Surgeons also consider your age and overall health when deciding if aneurysm clipping is right for you.

Aneurysm clipping might not be right for you if you:

• Are older than 40.
• Are in poor health.
• Have a chronic health condition.

Talk to your neurosurgeon about any questions you have about this procedure.

They'll tell you about:

• Tests you may need before surgery.
• What will happen during aneurysm clipping.
• What to expect after surgery and how long it will take to recover.

Aneurysm Clipping Surgery: What To Expect

Neurosurgeons perform aneurysm clipping using a type of brain surgery known as a craniotomy. Before surgery begins, you'll receive medicine to make you fall asleep (general anesthesia).

Once you're asleep, your neurosurgeon will:

• Clean your scalp and position you on the operating table. They may use a special device to hold your head in place.
• Make a small opening in your skull, usually behind your hairline.
• Use a specialized microscope to locate the blood vessel that supplies blood to the aneurysm.
• Insert a metal clip that looks like a tiny clothespin. They clip the artery where blood flows into the aneurysm (the neck), cutting off blood flow to it.
• Confirm that the clip has sealed off the aneurysm.
• Close the opening in your skull with thin metal plates and screws.
• Use stitches to close the opening in your skin.

The clip stays in your body forever to keep blood from flowing to the aneurysm. Stopping the blood flow helps prevent future bleeding and rupture.

Recovery After Aneurysm Clipping

After the aneurysm clipping procedure is complete, you'll stay in a recovery area.

Your care team will check your:

• Blood pressure.
• Breathing.
• Heart rate.

Doctors may give you medicine to prevent your brain from swelling. They may also elevate your head to help keep fluid from building up.

Once you've fully awoken from anesthesia, you may go to the ICU or a hospital room.

You'll stay in the hospital for a few days while your care team makes sure you're healing well. Neurologists will check how your brain is functioning, including your ability to respond to commands.

At the hospital, specialists will also check your brain function to see if specialty rehab might help you.

They may suggest you have:

• Physical therapy.
• Occupational therapy.
• Speech and swallowing therapy.