Microsurgery clamps brain aneurysms

The microsurgery of the brain aneurysm consists of many steps to take in turn, the ultimate goal is to actively control if the aneurysm has not ruptured or overcome the brain hemorrhage if the aneurysm has ruptured. Regardless of the circumstances, understanding the following steps of brain aneurysm surgery will reinforce the correctness of this treatment decision.

1. What is brain aneurysm clamping surgery?

Brain aneurysm clamping surgery is a surgery to cut off the flow of blood flowing to the brain aneurysm. This intervention was carried out to prevent vascular ruptures and hemorrhages in the brain. This is a cranial open surgery and is relatively complex. In it, the surgeon exposes the aneurysms by cutting the skull and placing a metal clip through the bottom of the aneurysm so that the blood cannot continue into this aneurysm. In recent years, titanium metal clamps have often been used with the advantages of inertness more prominently than other metal materials.

Laparoscopic surgery

Relatively complex brain aneurysm clamping surgery

2. What to prepare before surgery?

Pre-surgery preparation will be very different in the scene where the patient is taken to the emergency room with a ruptured brain aneurysm and aneurysm of the brain that has not yet ruptured.

For a situation where the brain aneurysm has ruptured and is life-threatening, the patient should be immediately taken into the operating room after doctors have determined the location of the aneurysm and the blood pressure has been temporarily controlled steadily. To lower blood pressure, the doctor may use intravenous drugs, increased ventilation on the ventilator or with sedatives. An in touch line due to invasive arterial pressure can be inserted into the artery at your wrist to monitor blood pressure. At this time, patients need to have absolute space to rest in bed, limit irritation so that blood pressure and other survival indicators are quickly stabilized.

In case the brain aneurysm does not rupture, the patient will be arranged to perform preoperative tests, such as blood tests, electroencephalies, chest X-rays … a few days before the surgery. In addition, the patient and his/her relatives or representatives will be explained by the doctor about the benefits and risks that may occur during the intervention. If agreed, the patient needs to fill out the paperwork and sign the consent form. After that, the anesthesi will examine and inquire about your medical conditions such as drug allergies, anaesthetic reactions, previous surgeries … to assess the patient's ability to tolerate this operation. In addition, the doctor also needs to know the medications that patients are taking, including prescription and over-the-counter, herbs … If you are taking non-steroidal and aspirin anti-inflammatory drugs, you should stop within a week before the surgery takes place.

Patients will be arranged for hospitalization the morning before surgery. Do not eat or drink anything from midnight until you get on the operating table. An intravenous line with an preferred solution is placed in a vein in the patient's arm. When everything is ready, an anesthesisithesisithesiy will explain the effects of the anesthesia and will conduct anesthesia.

3. How does the microsurgery procedure clamp the brain aneurysm?

The microsurgery procedure clamps the brain aneurysm with six steps. All these steps will take place in a period of 3 to 5 hours or maybe longer if the cranial cut is more complicated.

In turn the steps in the microsurgery procedure clamping the cerebral aneurysm are presented the following:

Step 1: Prepare the patient

  • The patient will lie on his back on the operating table and receive a full-body anesthesia.
  • Once fully infatuated and ventilated through the inn management, the patient's head will be placed in a tri-legged skull fixator, attached to the table to keep the head in place throughout the operation.
  • The hair area on the skull that needs intervention will be shaved clean and cut off the scalp, exposing the skull skeleton.
  • A drain can be placed in the lumbar spine to remove lumbar fluid, helping the brain to relax during surgery. In addition, cranial pressure can also be alleviated when the person is given a preferred solution, mannitol.

Step 2: Perform cranial surgery

  • Depending on the location of the brain aneurysm, a cranial bone flap at that location will determine and prepare to be removed.
  • After the scalp has been prepared, the surgeon will make a skin incision to reveal the skull. The skin and muscles are lifted out of the bones and folded.
  • Next, small holes are made on the base of the skull with drill bits. The borehole allows to open the entrance of the skull with a special saw.
  • The surgeons will cut off a bone window. The cutting bone flap is raised and removed to reveal the protective hard shell of the brain, known as the sural membrane.
  • The sural membrane will also be opened, revealing brain skin.

Step 3: Approach the aneurysm

  • When the sural membrane is opened, the brain meen will be revealed.
  • By working under a microscope, the surgeon carefully locates the arteries and track it to the aneurysm that needs intervention.
  • Before placing the clip, the surgeon will control the blood flow entering and exiting the aneurysm.
  • Aneurysm treatment should be very careful as it can cause rupture. If rupture occurs during surgery, a temporary clip can be placed on the original segment artery to prevent bleeding.
  • Depending on the size and location of the aneurysm, blood flow control may sometimes require access at the car carnous segment of the neck through a separate incision.

Step 4: Clip aneurysm clip

  • Usually the aneurysm is held tightly by the surrounding connective tissue. Therefore, it is necessary to peel off the aneurysm from other structures before being prepared for clamping.
  • Small arterial branches also need to be noted so that they do not clamp simultaneously in the clip.
  • The clip unfolds and is placed across the aneurysm neck. Once comprehensive control is guaranteed, the two jaws of the clip will tightly close the aneurysm from the original artery.
  • Multiple clips can be used at the same time with different aneurysms.
  • The clips are made of titanium and will survive on the arteries permanently.

Step 5: Check the clip

  • After clamping, the surgeon will need to check the clip again to make sure that the clip does not mistakenly clamp to narrow both the original artery or other arteries in the jaw of the clip.
  • The brain aneurysm is even pierced with a needle to ensure that the blood no longer fills it.

At the same time, the patient is also photographed with the cerebral artery system right in the operating room to be able to confirm the blood flow through the original artery.

Step 6: Close the skull cover

  • The sural membrane will be closed with sutures.
  • The bone flap is covered and fixed to the skull with titanium plates with fasteners.
  • The muscles and skin are also stitched together.
  • Finally, a soft gauze bandage will be placed on the cover of the incision.

aneurysm clamp

Microsurgery of brain aneurysm clamping consists of 6 steps

4. What care does it take after brain aneurysm clamping surgery?

After the surgery is over, the patient will be sent to the resuscitation room to continue monitoring for signs of survival until he wakes up

The patient will then be transferred to a neurological intensive care unit for follow-up throughout his hospital stay. Analgesic drugs will be in dinhed as needed. Some patients may have nausea and headaches after surgery; however, these symptoms are manageable with medication.

Patients are also encouraged to live in beds or to walk gently around the room as soon as possible. If everything stabilizes, after a few days the patient can be discharged from the hospital.

For cases of ruptured aneurysms, the patient needs to stay in the resuscitation department for 14 to 21 days and be monitored for signs of vascular spasms. This is a biological reflex of the cerebral blood vessels when a brain haemorrhage occurs and the consequences will lead to a second cerebral infarction. Arterial spasms can occur after 3 to 14 days. Signs of spasms include weakness of the hands or feet, confusion, drowsiness or irritation, wrestling.

When returning home, patients should be instructed how to take care of the incision and detect early signs of infection, and should rest regularly, avoid stress or excessive movement. If the patient has brain damage, it is possible to coordinate physical therapy or rehabilitation.

In summary, brain aneurysm clamping surgery is a classic method to prevent or address the consequences of cases of aneurysm in the brain. The design of the intervention depends on the characteristics of the aneurysm but the success of the operation depends on the compliance with the procedure, which requires meticulousness and accuracy in each of the above steps.

To register for examination and treatment at Share99 International Health Hub, you can contact Share99 Health System nationwide, or register for an online examination HERE

Source: winchesterhospital.org, bafound.org, sciencedirect.com

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About: John Smith

b1ffdb54307529964874ff53a5c5de33?s=90&r=gI am the author of Share99.net. I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.

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