Brain Aneurysm Surgery - Treatment Procedure and Recovery

An Aneurysm is characterised by a bulge or a balloon-like swelling in the wall of blood vessels. It occurs when blood flowing through blood vessels forces a weak vessel to bulge out. If it is not treated in time, it can burst which results in internal bleeding. Internal bleeding causes heavy blood loss and can eventually lead to death in one-third of cases. It can develop in any body part like the aorta, abdominal aorta, thoracic aorta, and brain. 

Procedure Name	Aneurysm Surgery
Alternative Name	Intracranial aneurysm
Conditions Treated	Repairing an aneurysm
Benefits of Surgery	Lifesaving Procedure, Minimally Invasive Surgery
Treated By	Neurologist

1. The purpose of the arteries is to supply blood from the heart to various body organs. The arterial wall is strong enough to sustain the persistent pressure exerted by the blood.
2. However, in some patients, there is a weakening of the arterial wall at some places, such as arteries supplying blood to the kidney, chest, neck, or brain.
3. When the blood exerts pressure on these weak arterial walls, they bulge out. The condition of bulging of arteries is known as an aneurysm.
4. As the bulging progress, the risk of rupturing of these arteries increases. An aneurysm may result in several physiological disturbances, depending upon the arteries affected with this condition. 

The main goal of aneurysm surgery is to prevent the risk of bleeding. Once an aneurysm is diagnosed, it has an increased probability to cause bleeding and it can be fatal.

Treatment of an aneurysm depends upon the location and type of aneurysm. The treatment alternatives available are:

1. Surgical Clipping: The surgeon makes an incision to reach the aneurysm. Then they place a metal clip on the neck of the aneurysm to stop the flow of blood to it. 
2. Endovascular Coiling: The surgeon inserts a catheter in the artery and guides it to the vessel with an aneurysm. Then they pass a soft platinum wire through the catheter to the aneurysm. The wire coils up in the aneurysm. It stops the flow of blood there and seals it off.

Before the Aneurysm Surgery

1. Make sure to reach the hospital before the scheduled time.
2. The aneurysm is often treated as emergency surgery. But, in case it is not an emergency, then inform your doctor about the medicines that you are already taking.
3. If you drink a lot of alcohol, inform your doctor.
4. The doctor will advise about the medicine you should or should not take before the surgery.
5. If you are a smoker, always stop smoking a few weeks before the surgery.
6. Strictly follow the instructions given by your doctor on not drinking and eating before surgery.
7. If the doctor recommends not eating or drinking before the surgery, take your routine medicines with a small sip of water.

On the day of Aneurysm Surgery

You may expect the following on the day of aneurysm surgery:

1. Always try to reach the hospital at least two hours before the time scheduled for surgery.  
2. You may undergo several tests, such as heart rate, blood pressure, breathing rate and other tests to rule out any disease that may increase the risk of complications during or after the surgery.
3. After reaching the hospital, the staff will ask to change and wear a surgical gown provided by the hospital.
4. They will wrap a bracelet on your wrist that contains a patient ID.
5. Before going for the procedure, they will ask the name, location, and type of surgery you are appointed for. It is done to avoid any mismatch and confusion in the surgery.

During the Surgery

1. The whole surgery procedure of an aneurysm is done under general anaesthesia and by expert surgeons. During the Surgical clipping of an aneurysm, the neurosurgeon puts an incision over the scalp, makes holes in the skull and enters the brain.
2. The aneurysm and its vessel are identified under an operating microscope. 
3. It is made sure that the surrounding normal vessels are left unharmed. 
4. Taking care of that, the aneurysm is occluded via a metal clip and the risk of haemorrhage is immediately nullified. 
5. Bleeding is controlled if any, and the wounds are sutured.

The staff shifts you to the recovery room immediately after the surgery. The patient needs to follow all the instructions of the surgeon until the sutures are healed. 

1. Hospital stay in case of endovascular surgery is about one to two days if there is no bleeding before the surgery. 
2. The hospital stay after clipping surgery is of about four to six days. However, the hospital stay can increase up to several weeks depending on complications after the surgery, like bleeding or narrowed blood vessels.
3. An imaging test of blood vessels, also called an angiogram, is done before discharging the patient from the hospital.

First Follow-up Appointment

1. Make sure to visit your doctor’s office within two weeks of discharge from the hospital.
2. The surgeon may perform imaging tests like angiograms, CT and MRI scans.
3. Always ask your surgeon about the measures to be followed for early and safe recovery.
4. If you have surgery for a brain aneurysm, you may need to go for regular follow-ups. It is done to ensure that the cerebral spinal fluid shunt is working correctly.

Immediately consult a doctor in case you are experiencing any of the following signs and symptoms:

1. Severe headache
2. Nausea
3. Vomiting
4. Loss of balance and coordination
5. Chest pain
6. Legs are swelling
7. Chills or fever over 100.5
8. Edges of the incision are pulling out
9. If there is the presence of blood and white fluid on the bandage

Complications due to delay in aneurysm surgery depend upon several factors. The doctors will comprehensively examine the severity of the risk of rupture.

The cost of Brain Aneusym Surgery ranges from ₹1,60,000 to ₹3,00,000 The cost varies based on the following factors:

1. Type of Brain Aneurysm Surgery
2. Age of the patient
3. The medical condition of the patient
4. The type of hospital facility availed - individual room or shared.

Procedure Name	Cost Value
Brain Aneusym Surgery	₹1,60,000 to ₹3,00,000