CEREBRAL ANEURYSM SURGERY
A brain aneurysm is the ballooning of the wall of a blood vessel within the brain. This common type of aneurysm is known as a saccular or berry aneurysm. A cerebral aneurysm develops in an artery usually in the front part of the brain that supplies oxygen-rich blood to the brain tissue. They can however, develop anywhere in the brain’s arterial circulation and there may be multiple aneurysms.
Because there is a weakened spot in the aneurysm wall, there is a risk that this aneurysm may rupture, causing bleeding in the brain, which can quickly become life-threatening.
WHEN IS ANEURYSM TREATMENT NECESSARY?
For the most part, most patients are unaware they have aneurysms unless they rupture. A ruptured aneurysm can cause a severe headache as a result of a bleed known as a subarachnoid haemorrhage. This requires urgent treatment as there is significant risk of the aneurysm rupturing again. Some patients however, become aware of an aneurysm as an incidental finding following a brain scan for a reason not related to their aneurysm. In these circumstances, lots of factors such as the aneurysms size and location will be taken into account in working out the risk of an aneurysm rupturing and will be used to devise a treatment strategy.
HOW IS A BRAIN ANEURYSM TREATED?
Depending on the shape, size and location of the aneurysm, the type of treatment will vary. The strategies used for treating an aneurysm are endovascular treatment and surgical clipping.
Endovascular treatment – In Johannesburg, Dr Profyris works together with a very experienced interventional neuroradiologist. Together, they will make an optimal plan for treatment of your aneurysm. Endovascular treatment will involve puncturing the groin and passing a catheter to the arteries in the brain. There, the aneurysm will be detected and depending on the configuration of the aneurysm it will be treated with a coil, stent and/or a flow diverter.
Surgical clipping – In selected cases, surgical clipping will be the best option for treatment. Dr Profyris, in Johannesburg, South Africa is experienced with clipping aneurysms and uses keyhole and minimally invasive techniques to decrease the exposure of normal brain and thereby decrease morbidity and increase rate of recovery. He also uses ICG to visualise blood vessels during surgery. This procedure involves carefully dissecting the blood vessel with the aneurysm (bubble) and occluding it from the circulation with a titanium clip. Most aneurysm operations can be performed with incisions of about 5-6 centimeters.