A brain aneurysm is a sac-like formation in a weakened area of a blood vessel in the brain. Filled with blood, the sac often causes no major symptoms; however, it may leak or rupture if the walls of the vessel become too fragile. Treatment for aneurysms typically involves neurosurgery; however, medical treatments are also available for patients not suited to surgery and to treat the complications of ruptured or leaking aneurysms.
Surgical Clipping
According to the Columbia University Medical Center, surgical clipping, or an open craniotomy, treats leaking or ruptured brain aneurysms. After removing a portion of the skull, surgeons locate the blood vessel that supplies blood to the aneurysm. They then place a clip at the neck of the aneurysm, right at the point where it receives blood from the vessel. Doctors put the skill back in place once clipping is complete.
The Mayo Clinic advises that this procedure can also seal off unruptured aneurysms in an effort to prevent them from leaking blood; however, the risks of the surgery may outweigh the potential benefits, so surgical clipping may not be appropriate in every case.
Endovascular Coiling
Endovascular coiling is a minimally invasive procedure. It does not require an incision into or removal of part of the skull. According to the Columbia University Medical Center, doctors insert a catheter into an artery in the groin area and delicately thread it up to the affected blood vessel in the brain. Then they insert small platinum wire coils into the catheter and into the aneurysm. Once in the aneurysm, they conform to the shape of the sac and cause the blood to clot, effectively sealing off the aneurysm and preventing further leakage of blood into the brain. Like surgical clipping, endovascular coiling can also treat unruptured aneurysms. Because this procedure proves less invasive, the risks are accordingly less prohibitive.
Medical Treatment
According to the National Institutes of Health, surgery may not be appropriate in all cases. For patients not well-suited for surgical treatment, various medical treatments can also treat or prevent a ruptured aneurysm. Activity restriction, bed rest and various medications can control blood pressure and headaches and prevent seizures associated with ruptured aneurysms. Patients can treat headaches with analgesics, or pain relievers, such as acetaminophen, while anti-epileptic medications such as phenytoin, valproic acid and levetiracetam may help to stop seizures, according to the Mayo Clinic.
Vasopressors--drugs which force a rise in blood pressure--may also be intravenously injected to prevent the occurrence of stroke which can occur as a complication of a ruptured aneurysm due to erratic blood vessel spasms and restricted blood flow.
Angioplasty
Angioplasty prevents stroke as a complication of hemorrhaging after a ruptured aneurysm. It involves the insertion of a small balloon via a catheter into a narrowed blood vessel in the brain. By inflating the balloon, surgeons can dilate a narrowed blood vessel and reduce the risk of stroke, according to the Mayo Clinic.
Brain Catheters and Shunt Surgery
Ruptured brain aneurysms can sometimes disrupt the circulation of cerebrospinal fluid around the brain and spinal cord, causing fluid to collect within the brain. As a result, pressure on the brain increases, potentially leading to brain tissue damage or death. According to the Mayo Clinic, doctors may insert catheters into the areas of the brain that have filled with fluid, draining the fluid out of the brain into a bag outside of the body. Shunt surgery--involving the creation of a drainage system of rubber shunts that helps drain fluid from the brain into the abdomen--presents another option.
