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Aneurysm (Brain) (cont.)

What is the treatment for a brain aneurysm?

Treatment for unruptured intracranial aneurysms is very controversial. Some investigators suggest that aneurysms less than 10 mm be left alone while those larger than that should be considered for treatment in patients less than 50 years old. The controversy lies in the surgical mortality and morbidity of surgically treated aneurysms. The mortality (death) rates can be as high as 3.8% and the morbidity (development of complications) can be as high as 15.7%. Many investigators suggest that aneurysms larger than 10 mm that are not associated with symptoms should be considered for treatment, especially in patients with coexisting medical conditions. Surgical treatment (clipping, in which the surgeon places a clip at the base of the aneurysm) is less likely in patients who have poor health or other serious medical conditions. Endovascular therapy or coiling (in which a small thin platinum wire is coiled into the aneurysm by a catheter in the blood vessel) is another surgical technique that can result in obliteration of the aneurysm. The goal of treatment for unruptured intracranial aneurysms is to prevent bleeding into the brain.

Ongoing bleeding of a brain aneurysm usually requires consultation with a neurosurgeon, interventional radiologist, and/or a neurologist. These individuals decide if surgery or interventional therapies such as coiling will be of benefit to the patient. For example, the neurosurgeon may decide to suction blood out of the area if it's not too large and hasn't caused catastrophic brain damage. Bleeding from a brain aneurysm is a medical emergency. Medical treatments for brain aneurysms that have bled are designed to reduce and/or alleviate symptoms. Nimodipine is used to prevent or relieve abnormal spasms of the arteries within the brain. Anti-epileptic drugs like phenytoin are used to treat and prevent seizures. Antihypertensive medications like labetalol can help reduce pressure on the blood vessel walls in the brain to lessen the chance of bleeding.

Medically Reviewed by a Doctor on 3/24/2014

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