Brain aneurysm surgery (clipping)

A brain aneurysm is a bulging, weak part of a blood vessel. It can put pressure on nerves. And it can bleed or break open (rupture).

One way to fix a brain aneurysm is with a surgery called clipping. This surgery can prevent strokes, bleeding, and brain damage.

You'll get medicine so you'll be asleep during the surgery. Part of your head may be shaved. The doctor makes cuts through your skull. The doctor puts a clip over the aneurysm. This stops the blood flow. The cuts in your skull are then closed.

After the surgery, you may stay in the hospital for 3 to 10 days. You will probably feel very tired for several weeks. You may also have headaches or problems concentrating. To fully recover, it can take 4 to 8 weeks.

Most people need to take at least 4 weeks off from work. But it depends on your job. For example, if you operate machinery at work, you may not be able to do that for 3 months.

You will get medicine so you will be asleep during the surgery. Part of your head may be shaved. To do the surgery, the doctor uses special tools to make cuts (incisions) in your scalp and through the bone of your skull. The doctor then places a tiny metal clip over the weak part of the blood vessel. This stops the flow of blood.

Next, the doctor uses small metal plates and clamps to put the piece of your skull back. Then the doctor closes the incisions with stitches or staples. The incisions leave scars that fade with time.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Rest when you feel tired. It is common to want to sleep during the day. It is a good idea to plan to take a nap every day. Getting enough sleep will help you recover.
• You may need to take off from work at least 4 weeks, depending on your job. Ask your doctor when you might return to work.
• Try not to lie flat when you rest or sleep. You can use a wedge pillow, or you can put a rolled towel or foam padding under your pillow. You can also raise the head of your bed by putting bricks or wooden blocks under the bed legs.
• As you get up after lying down, bring your head up slowly. This can prevent headaches or dizziness.
• You can wash your hair 2 to 3 days after your surgery. But do not soak your head or swim for 2 to 3 weeks.
• Do not dye or color your hair for 4 weeks after your surgery.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid heavy lifting until your doctor says it is okay.
• Do not drive for 2 to 3 weeks or until your doctor says it is okay.
• Ask your doctor when it is safe for you to travel by plane.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Follow your doctor's orders about how much fluid you should drink after surgery.
• Do not drink alcohol until your doctor says it is okay.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. Your doctor will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• If you get medicines to prevent seizures, take them exactly as directed.

Incision care

• If you have strips of tape on your incisions, leave the tape on for a week or until it falls off.
• Keep the area clean and dry. Change the bandage every 2 days, or if it gets wet or soiled.
• After your doctor says it is okay to shower or bathe, gently wash the surgery area with warm, soapy water and pat it dry.

Exercise

• Avoid risky activities, such as climbing a ladder, for 3 months after surgery.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for 3 months or until your doctor says it is okay.
• Do not play any rough or contact sports for 3 months or until your doctor says it is okay.

Ice

• For the first 1 or 2 days, you can use ice to reduce pain, swelling, and itching. Put ice or a cold pack on your head for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.