Brain Aneurysm Surgery Overview

About five million people in the United States have some form of brain aneurysm. Expert and prompt evaluation and treatment of this condition is critical, as a brain aneurysm rupture is fatal in 50 percent of patients and causes severe neurologic deficits in 25 percent of patients.

What is a brain aneurysm?

A brain aneurysm is a disorder in which a weakened wall of a blood vessel causes the vessel to balloon or dilate. The aneurysm can eventually rupture and cause bleeding in the brain. The risk of rupture depends on a number of factors, such as the size and shape of the aneurysm.

What are some common brain aneurysm symptoms?

Brain aneurysm symptoms depend on the nature of the brain aneurysm. A small unruptured brain aneurysm may produce no symptoms at all. A large unruptured aneurysm may cause pupil dilation, blurred vision, numbness on one side of the face, or a drooping eyelid. A leaking aneurysm can cause a sudden and severe headache, but typically no other symptoms. When a brain aneurysm ruptures, the patient will experience a sudden and severe headache and may also experience nausea, vomiting, neck stiffness, seizure, confusion, blurred vision, light sensitivity, drooping eyelid, or unconsciousness.

What are surgical options for brain aneurysms?

At Brigham and Women’s Hospital (BWH), a team of neurosurgeons, interventional neuroradiologists, and neurologists work together to determine the best treatment for each patient with a brain aneurysm. Small aneurysms are often observed with non-invasive imaging studies such as a magnetic resonance angiography (MRA) or computed tomography angiography (CTA). When brain aneurysm surgery is recommended, our specialists typically use microsurgical or endovascular (through a blood vessel) approaches.

The best treatment for each aneurysm is determined by a number of factors, including the vascular anatomy surrounding the aneurysm and the structure of the aneurysm itself. Surgical approaches include clipping of aneurysms (using a clip to isolate an aneurysm from normal circulation), bypasses for aneurysms with unusual anatomy, refined microsurgical techniques, and advanced intraoperative imaging. Endovascular approaches include coiling (tiny coils that promote clotting and close off an aneurysm), stent coiling or flow diversion.

Patients with ruptured aneurysms are treated by a team of specialists in the neurosurgical intensive care unit.

Endovascular Coiling Procedure: This video animation demonstrates the treatment of a brain aneurysm by inserting coils into the aneurysm both without and with the assistance of a stent to block the blood flow into the aneurysm, but still allow blood to flow in the regular vessel. (This animation does not have sound.)

Flow Diversion Stent Procedure: This video animation demonstrates a flow diversion stent procedure, which is one type of endovascular technique to treat brain aneurysms. (This animation does not have sound.)

Stent-Assisted Coiling Procedure: This video animation demonstrates the endovascular treatment of a brain aneurysm by inserting coils into the aneurysm with the assistance of a stent to block the blood flow into the brain aneurysm but still allow blood to flow in the regular vessel. (This animation does not have sound.)

Neurosurgical Care at Brigham and Women’s Hospital

The Department of Neurosurgery at Brigham and Women’s Hospital, as well as the neurosurgery field in the U.S., were founded by Dr. Harvey Cushing in 1913. Since that time, our team has been devoted to the advancement of neurosurgical care, research, and education. A multidisciplinary staff of more than 100, including 13 clinical faculty, work together to provide patient-focused, world-class medical care for the entire spectrum of neurological diseases. We provide state-of-the-art treatment through revolutionary techniques and advanced technology, such as our Advanced Multimodality Image Guided Operating (AMIGO) suite.

Our neurosurgeons provide care at Brigham and Women’s Hospital in Boston, as well as some of our community hospitals. They perform more than 2,500 surgical treatments each year at these locations for patients from local, national, and international communities.

Patient- and Family-focused Care

Brigham and Women’s Hospital (BWH) has long been committed to not only the care of our patients, but also the many other needs that they and their families have. This philosophy of patient- and family-focused care – involving systems and services that emphasize healing in a comfortable, relaxed environment – is a guiding force behind the care we provide at the Department of Neurosurgery.

Quality of Patient Care

BWH is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and follow established protocols that have been shown to improve patient outcomes. Our Inpatient Satisfaction Survey, sent to patients’ to assess their total care experience, helps us to monitor what we are doing well and areas for improvement. We pride ourselves in the Quality of Patient Care we provide and how we compare with other hospitals.

Brigham and Women’s Hospital Cerebrovascular Team

The Brigham and Women’s Hospital Cerebrovascular Center is dedicated to providing the best diagnosis, treatment, care and outcomes for patients suffering from a wide range of cerebrovascular disorders including those needing brain aneurysm surgery. The multidisciplinary program involves a team of neurosurgeons, interventional neuroradiologists, neurologists, and radiation specialists, who offer a complete spectrum of therapies for the diagnosis and treatment of vascular disorders of the brain and spinal cord. Meet the Cerebrovascular Center Team.

Do you have additional resources on brain aneurysm surgery?

How can I contact you?

If you believe you should have an evaluation and would like to schedule an appointment with one of our neurosurgical experts, call (617) 732-6600 to speak to one of our knowledgeable coordinators who can help to connect you to the doctor that best meets your needs or fill out an online appointment request form.


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