Aneurysm clipping is a surgical procedure, performed to treat an aneurysm in the brain. An aneurysm is an abnormal bulging of an artery within the brain. Left untreated, an aneurysm may rupture and cause a subarachnoid hemorrhage, which is bleeding into areas within the brain, or a hematoma, a collection of blood within the brain. These are serious conditions that may be life-threatening. In the aneurysm clipping procedure, the surgeon places a small metallic clip along the neck of the aneurysm. This prevents blood from entering into the aneurysm sac, which decreases the chances of rupture and bleeding. Once an aneurysm is clipped, the clip remains in place and the aneurysm will shrink in size and scar down permanently after clipping.

There are two different kinds of aneurysms: ruptured aneurysms, which require immediate treatment to prevent life-threatening bleeding, and unruptured aneurysms, which are not life-threatening but should be removed to prevent any future rupturing. Aneurysm clipping surgery aims to separate the aneurysm from adjacent, properly-functioning arteries without damaging them.

The aneurysm clipping procedure is performed while the patient is sedated under general anesthesia. The head will be placed into a three-pin skull fixation device, which keeps it in place for the duration of the procedure. Next, a portion of the scalp (usually behind the hairline) will be shaved, and an incision is made in the area. Once the skull has been uncovered, a craniotomy, or opening in the skull, will be made to allow access to the dura mater, the protective coating surrounding the brain. Then, the dura mater is carefully opened to expose the brain. Once the aneurysm has been located, and its blood flow has been successfully controlled, a clip is placed along the neck of the aneurysm. As soon as the surgeon verifies that the clip is not obstructing any nearby arteries, the dura mater is sutured shut, and the bone of the skull is reattached with titanium plates and screws. The skin is then sutured back together. A soft dressing is then placed over the site of the incision.

As with all surgical procedures, there are certain risks associated with aneurysm clipping. These risks may include allergic reaction to the anesthesia, as well as:

• Infection
• Seizures
• Brain swelling
• Vasospasm

An improperly placed clip may also inadvertently block off a healthy artery.

After aneurysm clipping, the patient will remain in the hospital for an average of four to six days. Some patients may stay as long as three weeks for monitoring if the aneurysm had ruptured and bleeding occurred. There may be minimal restrictions on physical activity when the patient is discharged from the hospital. Full recovery after an aneurysm. clipping takes about six weeks. Follow-up with a doctor may be required to monitor for any evidence of aneurysm recurrence.

• MedlinePlus
• National Institutes of Health
• Centers for Disease Control and Prevention
• Eunice Kennedy Shriver National Institute of Child Health and Human Development
• U.S. Department of Health & Human Services
• U.S. National Library of Medicine
• WebMD