Brain Aneurysm Surgery

For open surgical treatment of ruptured and unruptured aneurysms, microsurgical clipping is the typical treatment of choice. In rare instances, the neurosurgeon may combine bypass procedures with occlusion (closing off) of the aneurysm.

You will be under general anesthesia, meaning you’ll be fully asleep for this procedure. The neurosurgeon removes a section of the skull, uses a microscope to locate the aneurysm and puts a small titanium clip(s) at the base or neck of the aneurysm. Similar to a tiny clothespin, the clip pinches the neck of the aneurysm and stops its blood supply. The surgeon replaces the skull and closes the scalp. The clip stays in place, the aneurysm shrivels, and the long-term prognosis is excellent.

While the surgery itself has changed little in recent years, there have been dramatic advancements in clip technology and use. Today, there are increasingly smaller and thinner clips. Our neurosurgeons were among the first in the country to use them. In addition, thanks to special, very low-profile appliers, surgeons can insert these clips through tiny incisions.

If you have Moyamoya disease or if your neurosurgeon needs to build a new artery to reroute blood around a diseased vessel, we can use this procedure. Our surgeons are expert in performing extracranial-to-intracranial (ECIC) bypass. We take the artery on the side of the scalp (the superficial temporal artery), open the skull and sew it to the artery inside the head.

Alternately, your neurosurgeon may do the bypass using the long saphenous vein from the leg. In this case, we connect the saphenous vein graft to the carotid artery in the neck, pass it under the skin and sew it to the middle cerebral artery inside the head.

Experts at the Brain Aneurysm Institute excel at treating arteriovenous malformation (AVM). If you have an AVM that is bleeding and easy to reach, your care team may recommend surgery to remove the tangle of vessels.

Dural Arteriovenous Fistula (DAVF) is an abnormal connection between the arteries within the dura mater (the thick membrane that covers the brain and spinal cord) and the veins that drain the brain.

During surgical repair, the neurosurgeon disconnects the artery from the vein.

Our multidisciplinary group excels at performing this repair with endovascular technique. During this, we use a minimally invasive approach through the groin artery. In some cases, your care team may suggest open surgery for DAVF.

A carotid body tumor is a growth in the carotid artery, the blood vessels in the neck that carry blood to the brain. After an embolization to block the blood vessels that feed the tumor, your care team may suggest an open procedure. During this surgery, your neurosurgeon can safely remove the abnormal growth.