Treatment options

The decision to treat an unruptured cerebral aneurysm depends on a number of factors including:

• Type of cerebral aneurysm
• Size and location of the aneurysm
• Patient’s age
• Patient’s overall health
• Risk versus benefit of treatment

Small aneurysms within the brain have a lesser chance of rupture, and are best left untreated. These aneurysms are commonly observed with regular CT or MR scans.

William Thorell ,M.D., neurosurgeon has specialized training in endovascular neurosurgery and offers several new procedures to diagnose and treat cerebral aneurysms. This allows the patient and the surgeon to choose the treatment option best suited to their individual neurological condition.

Surgical Clipping

In this procedure, the surgeon removes a section of the skull, in a procedure called a craniotomy. Once the aneurysm is located within the brain, a tiny clip is placed across the neck of the aneurysm to isolate it from the normal circulation. This titanium clip remains on the aneurysm permanently.

Endovascular Coiling

Endovascular coiling is a less-invasive technique that does not require opening the skull. In this procedure, the neurosurgeon threads a tiny catheter through an artery in the groin, and guides it to the location of the aneurysm. Tiny platinum coils are then threaded through the catheter to fill the aneurysm, blocking blood flow and preventing rupture. Endovascular coiling of a cerebral aneurysm is also referred to as embolization.

Clipping or coiling?

Deciding how to treat a cerebral aneurysm is complicated and requires careful consideration, based on many factors. Deciding to treat the aneurysm with surgery or embolization must be weighed against the risk of observation and possible aneurysm rupture. The risk of rupture is difficult to determine and is influenced by a multitude of factors including size and location of the aneurysm, family history of cerebral aneurysm rupture, tobacco abuse, and overall health of the patient. Depending on the aneurysm, risk of rupture can vary from 1 to over 15 percent a year. It important to note that there is a 30 percent mortality rate when a cerebral aneurysm ruptures. Individuals who survive an aneurysm rupture have an even higher risk of neurological disability.