How are brain aneurysms treated? Do they always require open brain surgery?

Not always – there are two main approaches to treat an aneurysm and prevent it from bleeding: microsurgical clipping and endovascular coiling. In clipping, a neurosurgeon performs a craniotomy (opens a small window in the skull) and places a tiny metal clip across the neck of the aneurysm. This clip seals off the aneurysm so blood can’t enter it, effectively eliminating the risk of rupture. Clipping has been used for decades and is very effective, with a low chance of the aneurysm ever coming back. The other approach is coiling, which is minimally invasive (no big opening in the skull). In coiling, a neuro-interventionist threads a catheter through an artery (usually from the groin or wrist) up into the brain and then fills the aneurysm with soft platinum coils or uses tiny flow-diverting stents. Coiling works by clotting off the inside of the aneurysm from within, so it can’t fill with blood. Both treatments have their pros and cons: clipping is a one-time durable fix (aneurysm rarely recurs), but involves open surgery, whereas coiling is less invasive with typically quicker recovery, but sometimes aneurysms can recur and need future check-ups. The choice depends on the aneurysm’s size, shape, location, and the patient’s overall health. Dr. Murali Mohan S and his team will evaluate what’s safest and best for your specific aneurysm. The goal in both methods is the same – to secure the aneurysm so it will not bleed.