Brain Aneurysm Surgery: Long-Term Care

A brain aneurysm repair can change your life in a number of ways. The surgery can reverse or prevent progression of neurological deficits caused by a brain (cerebral) aneurysm. Brain aneurysm surgery can be done for ruptured or unruptured aneurysms.

After having an operation to relieve the effects of a ruptured brain aneurysm, long term care and lifestyle adjustments may be necessary, even after post-operative healing is complete.

Benefits of Surgery 

Brain aneurysms are defects in the arteries. They can bleed due to rupture and cause severe consequences. Surgery can prevent a brain aneurysm from bleeding, and it can also minimize the harmful impact of a bleeding or non-bleeding brain aneurysm.

A brain aneurysm might not cause any effects if it is not bleeding. But even small and unruptured brain aneurysms can cause deficits, such as double vision or weakness. Repair of an unruptured brain aneurysm can relieve these symptoms, although sometimes the effects may be permanent if irreversible neurological damage has already occurred prior to the repair. 

A leaking or ruptured brain aneurysm can bleed rapidly or slowly. The bleeding produces increased intracranial pressure (swelling in and around the brain), and it also interferes with blood flow to the brain. As a consequence, a bleeding brain aneurysm may cause a number of neurological deficits. 

Effects of a bleeding brain aneurysm can include:

• Severe headache 
• Loss of vision 
• Confusion 
• Behavioral changes 
• Difficulty communicating 
• Weakness or paralysis on one side of the body 
• Seizures 
• Loss of consciousness 

These consequences can be temporary or permanent. Surgery can be done to remove the blood, relieve swelling, and repair the aneurysm to help alleviate some of the symptoms. Sometimes it is too late to reverse some of the effects, but surgery may prevent the consequences from worsening.

Possible Future Surgeries 

Generally, repair of a brain aneurysm and removal of blood is intended to be done during a single procedure. However, sometimes complications can arise, necessitating another urgent surgery.

Sometimes additional post aneurysm repair procedures are planned, such as when severe edema (swelling and fluid) necessitates a craniectomy or a shunt placement during aneurysm surgery. 

Follow-up Surgery 

Often, at the time of aneurysm surgery with severe intracranial pressure, further surgeries are planned. A craniotomy is a type of brain surgery in which a portion of the skull is removed for surgical access to the brain.

A craniectomy is a similar procedure in which a portion of the skull is removed to relieve intracranial pressure, and it is not replaced at the end of surgery. This procedure is done because the skull encloses the brain, and when excess pressure is present, it can cause severe brain damage.

The portion of the skull is placed back into position after edema resolves—which can take days or weeks after a major bleed from a ruptured brain aneurysm. 

Shunt

A shunt is a small tube that drains fluid. Your neurosurgeon may place a shunt underneath the skull if you have severe swelling, especially if the swelling is chronic. Later, the shunt might be removed, or you may need a shunt revision if it becomes obstructed or clogged. 

Complications 

Complications after aneurysm surgery may include further bleeding, leaking of the aneurysm, infection, swelling, and more. Surgical interventions may be needed to manage these complications.

For instance, rebleeding can occur, and this may require another surgery for surgical removal of the blood and/or additional aneurysm repair. And severe post-operative cerebral swelling may be treated with craniectomy or a shunt, even if that wasn’t done during your initial aneurysm repair.

Lifestyle Adjustments

After recovering from prophylactic brain aneurysm surgery, you shouldn’t have lasting neurological deficits that you didn’t have prior to the surgery. But you may have to make a number of long-term lifestyle adjustments after you have surgery for a ruptured brain aneurysm.

The bleed from a ruptured brain aneurysm can cause substantial brain damage that may affect your abilities. Learning to optimize your abilities is a big part of your long-term care and can remain a part of your lifestyle for many years. 

Rehabilitation 

Your rehabilitation process can take months or years. Consistency and maintaining a positive outlook are vital components of relearning any abilities that may have declined as a result of your brain aneurysm rupture.

You can experience issues like muscle atrophy due to diminished physical activity during a long recovery. And you may develop anxiety or depression in response to the changes that you have gone through due to your brain aneurysm rupture and surgery. 

Some treatments that you can anticipate on an inpatient or an outpatient basis include:

• Physical therapy to help you regain muscle strength and control
• Occupational therapy to help you with self-care, like getting dressed
• Speech therapy to help you communicate with others
• Swallow therapy to help you learn to eat safely if you have trouble swallowing
• Psychological counseling to help you manage your feelings as you adjust to the changes in your life after brain aneurysm surgery

Resuming Activity 

You might eventually be able to resume your regular activities after your brain aneurysm surgery. But if you have a residual neurological deficit, such as impaired vision, difficulty with balance, or diminished concentration, you may need to make adjustments to activities such as driving, your job, walking, exercising, and self-care.

For instance, you might need to use a walker or a cane to get around safely, or you may need assistance when you use stairs. These adjustments can be determined by working with your healthcare provider and therapist to figure out your abilities and limitations. 

Home Care 

After a brain aneurysm surgery, you might need help at home. Your healthcare provider or therapist might recommend that you have someone come to your home to help with medications, check your laboratory tests, or evaluate your physical progress.

Caregivers 

Loved ones who live with you can experience a substantial burden after your brain aneurysm surgery if you need to rely on them more than you used to. If you or your caregivers need additional help, talk to your healthcare provider or therapist. Also consider seeking out a community from a support group to meet with others who have gone through a similar experience.

A Word From Verywell

Long term care needs after brain aneurysm surgery differ for each person. The amount of care you will need and the duration of that care is largely determined by the extent of neurological decline caused by the brain aneurysm.

You and your loved ones can and should be very involved in your care. Managing your daily life after a brain aneurysm surgery requires patience and, possibly, a number of lifestyle adjustments.