FAQs about Brain Aneurysm Procedures
What can I bring to the hospital?
Lists of all medications, contact numbers of personal physicians, reading material.
How long does the coiling procedure take?
Approximately 1½-3 hours.
How long does surgery take?
Approximately 3-4 hours.
How long should I expect to be hospitalized?
The length of hospitalization is significantly different for patients with ruptured (sub-arachnoid hemorrhage) versus unruptured (incidental) aneurysm. Patients with incidental aneurysms typically have a short hospital stay of approximately one week. The length of hospitalization of patients who have suffered subarachnoid hemorrhage is variable and is dependent on the condition of the patient on admission and the treatment of concomitant issues such as cerebral vasospasm, hydrocephalus and ventilatory issues. In patients with severe sub-arachnoid hemorrhage, hospitalization may be several weeks. In uncomplicated subarachnoid hemorrhage, hospitalization is typically 10-14 days.
Will an Intensive Care Unit (ICU) stay be necessary?
All treated aneurysm patients (endovascular coiling or microsurgical clipping) are monitored in the Intensive Care Unit in the immediate post-treatment period. The length of stay is dependent on whether or not the patient has had a sub-arachnoid hemorrhage and additionally in the presence of other medical and neurosurgical issues. Uncomplicated, unruptured aneurysms are usually in the ICU for 1-3 days after treatment.
Is general anesthesia used for surgery and coiling?
Yes, for both. General endotracheal anesthesia is used and an attending anesthesiologist who is experienced in neuro-anesthesia is present at all times.
How long do I need to be on anti-convulsant medications (Dilantin, Keppra etc.) after surgery, sub-arachnoid, or endovascular coiling?
Most patients are weaned off theses medications in a few months. Very few patients need to be on these medications chronically. Frequently, a neurologist helps in the modulation of the dosages during the weaning process.
Can I have visitors while I am in the hospital?
When can I get out of bed?
Patients with unruptured aneurysms get out of bed on day #1 after treatment. Quick mobilization and early activity are critical parts of recovery. Patients who are on ventricular drainage may get out of bed with nursing assistance.
When can I shower/wash my hair?
After all sutures have been removed.
When will the incision be healed?
Incisions after aneurysm surgery heal quickly, usually in 1-2 weeks. After endovascular coiling, there is quick healing of the puncture site in the groin. If there is any pain or swelling in this area, contact your doctor immediately.
Will I get prescriptions for pain medications upon discharge?
Yes, you will be provided with a clear set of instructions and prescriptions at the time of discharge. We are available on 24/7 basis after you return home for any questions.
How long am I going to be on medications?
Most aneurysms patients are off all medications within 1-3 months. Anticonvulsant drugs are used in the initial post-operative period, but are eventually weaned. Other medications, for instance, anti-hypertensive drugs, will A physical therapy program is tailored for each individual patient. Moderate activity after discharge is be modulated by your internist. After endovascular coiling, selected patients may be on “blood-thinners”, such as Plavix® or aspirin.
What can I do to have the most successful recovery?
Follow all post-operative instructions regarding medications and post-operative therapy. Call your doctor immediately if there are any issues. Have a positive outlook! In the end, most aneurysm patients have significant recoveries after sub-arachnoid hemorrhage and treatment.
When can I be active again?
Early activity is the cornerstone of recovery. We advocate, in conjunction with our physical therapy staff, early mobilization in the hospital and a program of home rehabilitation and physical therapy for the post-operative period. Every patient is different; the return to full activity after an aneurysm operation or aneurysm coiling is dependent on the condition of the patient prior to the treatment. Patients with unruptured aneurysm typically return to full activity quite quickly.
How soon can I drive?
This frequently asked question has no specific answer and varies from patient to patient. Patients with unruptured aneurysms are usually instructed to wait about four weeks after uncomplicated surgery, before driving. Patients who have had unruptured aneurysms treated with endovascular coiling typically can drive sooner. Patients who have suffered subarachnoid hemorrhage may return to driving after clearance from both their neurosurgeon and neurologist.
How soon can I return to work?
This is specific for each patient, their pre-treatment and post-treatment condition, and, of course, the demands of their job. Consult your doctor.
Can I dye my hair after surgery?
Yes. After coiling you may dye your hair immediately. After surgery, we suggest a two month wait.
How is treatment (clipping versus coiling) decided?
The decision regarding the modality of treatment is depended on many factors, including the age and condition of the patient, the size of the aneurysm, the shape of the aneurysm, and the location of the aneurysm. After angiography is completed, our team of neurosurgeons and interventional neuroradiologists review the films and then decide on the appropriate treatment modality, specifically for each patient.
Can the coils move or shift?
This is unlikely. We do monitor the coil mass with follow up MRA (magnetic resonance angiogram) and angiography. In rare circumstances, an aneurysm can partially open, requiring further intervention.
Can I have an MRI after clipping or coiling?
All platinum coils are MRI compatible. Titanium aneurysm clips are MRI compatible. Make sure to check with your neurosurgeon, prior to MRI, if you have had surgery for a brain aneurysm (to confirm clip type).
Will the coils or clips set off a metal detector at an airport?
Are children at risk for aneurysms?
Aneurysms are extremely rare in children. The average age for aneurysmal sub-arachnoid hemorrhage is approximately 55 years of age.
If an aneurysm has been discovered; for how long has it been present?
Aneurysms may slowly enlarge over time, yet the rate of growth is not completely understood. Some aneurysms, typically smaller aneurysms, may remain quiescent for decades.
Can I develop another aneurysm?
This is extremely unlikely. We check all of the brain arteries in the initial angiogram. Patients who are quite young (under 40) may be candidates for follow-up angiography later in life.
Could previous head trauma have caused the aneurysm?
No. Congenital cerebral aneurysms and head trauma are not related.
Do I need a long-term follow up after my treatment and discharge form the hospital?
After coiling, imaging follow-up (MRA, angiography) is necessary to confirm persistent occlusion. Early angiographic follow up is performed after microsurgical clipping. Sometimes long-term follow up is recommended.