This document discusses a rare brain surgery performed at Ivy Hospital to treat cerebral aneurysms in a 30-year-old male patient. An angiogram revealed the patient had two aneurysms, one of which had burst, causing bleeding in his brain. Dr. Vineet Saggar successfully clipped the aneurysms during surgery. The document then provides background information on aneurysms, including their causes, signs and symptoms, and current treatment options of surgical clipping or endovascular coiling.

1. INTRACRANIAL ANEURYSMS
DR VINEET SAGGAR M.B.B.S, MS, MCH(NEUROSURGEY)
CONSULTANT DEPARTMENT OF NEUROLOGICAL AND
SPINAL SURGERY IVY SUPERSPECIALITY HOSPITAL SEC-
71, MOHALI. PUNJAB

2. CASE – A RARE BRAIN SURGERY
- Neurovascular surgery( surgery of blood vessels in brain)
is technically most demanding of neurosurgical procedures
- A rare neurovascular surgery was performed at ivy
hospital few days back
- A 30 years old male was admitted in our hospital with
headache followed by loss of consciousness. .Patient had
experienced similar episode few days back which was
ignored by local general practitioner and he was
discharged on analgesics

3.  Before coming to us he was seen by
neurosurgeons in tricity was refused
treatment due to risk involved in the surgery
 We did angiography of brain vessels and
found not one but two ANEURYSMS( Balloon
like dilatation in wall of brain vessels) in his
brain vessels , one of which has burst causing
massive hemorrhaged in his brain

4. Angiogram Showing 2 Aneurysms

5. Angiogram Showing 2 Aneurysms

6.  Aneurysms were successfully clipped by Dr
Vineet Saggar on 9/5/12
 Patient remained in hospital for18 days and
was discharged on 28/5/12

7. WHAT ARE ANEURYSMS
 A cerebral or brain aneurysm is a
cerebrovascular disorder in which weakness
in the wall of a cerebral artery or vein causes a
localized dilation or ballooning of the blood
vessel.
 The general incidence of aneurysms in the
population at large is of the order of 1%-2%
 Multiple aneurysms occur in 0.2% of the
population

9. SIGNS AND SYMPTOMS
 Most common symptom is sudden severe
headache that can last from several hours to
days
 nausea and vomiting
 drowsiness and/or coma

10.  The ruptured aneurism (hemorrhage) may
also damage the brain directly, usually from
bleeding into the brain itself. This is called a
“hemorrhagic stroke.” This can lead to:
 weakness or paralysis of an arm or leg
 trouble speaking or understanding language
 vision problems
 seizures

11. CAUSES
 Aneurysms may result from congenital
defects(MOST COMMON CAUSE),
 Preexisting conditions such as high blood
pressure and atherosclerosis (the buildup of fatty
deposits in the arteries), or head trauma.
 Cerebral aneurysms occur more commonly in
adults than in children but they may occur at any
age.
 They are more common in women than in
men, by a ratio of 3 to 2.

12. TREATMENT
Currently there are two treatment options for
securing intracranial aneurysms:
 Surgical clipping
or
 Endovascular coiling

13. ANEURYSM CLIPS

14. SURGERY V/S COILING
 Although endovascular coiling is associated
with a shorter recovery period as compared
to surgical clipping, it is also associated with a
significantly higher recurrence rate after
treatment
 Also coiling may not be the best options in
patients with giant aneurysms , wide neck
aneurysms or patients with massive bleed or
large clots in brain as was in our case .