Brain Aneurysm Treatment

Procedure

Not every brain aneurysm requires treatment. For small aneurysms with a low risk of bleeding, regular imaging follow-up may be sufficient.

If treatment is necessary, there are generally two established methods available:

Microsurgical Clipping

Through an incision in the skull (craniotomy), the cerebral aneurysm is visualized under a surgical microscope and permanently isolated from the bloodstream using a specially designed titanium clip. Blood flow to the adjacent vessels is maintained. For unruptured cerebral aneurysms, this surgery is typically performed at the USZ through a very small incision (mini-craniotomy).

Catheter-based treatment (endovascular therapy)

Fine instruments are guided to the brain aneurysm through a thin catheter, which is usually inserted through the groin. Depending on the situation, this is either closed from the inside using platinum coils (coiling) or treated with stents or flow diverters, which alter blood flow in such a way that the aneurysm closes.

Figure 1: Treatment methods for cerebral aneurysms. Left: In microsurgical clipping, a small incision in the skin is used to create an opening in the bone to gain access to the brain (known as a “mini-craniotomy”). The aneurysm is then visualized and closed from the outside using a titanium clip. Right: In catheter-based “coiling,” the cerebral aneurysm is filled from the inside with fine platinum coils delivered through a thin tube, thereby sealing it off.

Experienced specialists in neurosurgery and interventional neuroradiology work together to determine which procedure is recommended. At the USZ, patients are actively involved in the decision-making process by having treatment options explained to them in a way they can understand. The goal is to permanently isolate the cerebral aneurysm from the bloodstream while minimizing the risks associated with the procedure as much as possible.

Treatment for a ruptured brain aneurysm is immediate. The goal is to seal the ruptured aneurysm as quickly as possible to prevent further bleeding. The choice of procedure is made around the clock by an interdisciplinary team.

Preparation

Preparation depends on the chosen treatment method and the individual situation. In the case of an unruptured cerebral aneurysm, treatment planning takes place during a consultation and after a careful assessment of the risks. A ruptured brain aneurysm is a medical emergency, so treatment is initiated immediately.

Follow-up Care for a Brain Aneurysm

After treatment, follow-up visits are scheduled to assess the success of the treatment and monitor the patient’s progress. In the case of a ruptured cerebral aneurysm, monitoring and treatment in a neuro-intensive care unit are necessary after the procedure so that any complications can be detected and treated early.

Depending on the treatment method and the individual course of the disease, additional outpatient follow-up visits and imaging studies will be scheduled.