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Chances of BRAIN ANEURYSM to rupture without surgery.

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I asked a doctor on this site a question about my dad who has a 5mm brain aneurysm (that has previously bled a little and clotted by itself) that needs to be operated on, either by clipping or coiling. But he also has a blocked right carotid artery that needs to be cleared (about 95% blocked.) The neurosurgeon has decided he will probably get the artery cleared first as he needs more blood flow to the brain when he treats dad's aneurysm. But wouldn't fixing the artery first result in a rush of blood flowing to the brain which could then result in rupturing the aneurysm?
Would you fix the aneurysm first or the blocked artery? I'm worried that clearing the carotid artery will rupture his aneurysm.
Thankyou.

Category: Neurosurgeon

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Category: Spine Surgeon
 23 Doctors Online

Hello,
Thanks for your query at DoctorSpring.com
I understand your concern
Before I can comment, please let me know where exactly is the aneurysm arising from.
Also can you upload reports of the investigation done so far?
Please feel free to discuss
Thanks
.


Patient replied :

Unfortunatley I don't know where it is for sure. Dad will find out in a few days when he has a meeting with the neurosurgeon. I know it's 4mm by 5mm saccular towards the rear of the brain on the left side... I'm not sure what artery it's on at all. The neurosurgeon said something about he would be using the brain's rear arteries to push the coiling through to the aneurysm and that is why he wants the carotid cleared because the front arteries will need to be working at their fullest. We first thought they would be doing clipping but he seems to be leaning towards coiling now. I don't have any records as they are at my dads place.


Dear Sir,

Each aneurysm has a different way of handling. Some are best handled by surgery; some by coiling. Many can be handled in both ways. The flow dynamics in aneurysm patients is a complex entity. So, knowledge the same is mandatory. Please revert back to me with the location of the aneurysm and the exact plan of management proposed by the treating neurosurgeon & in which place is he consulting.
Regards.


Patient replied :

So I still haven't found out exactly on what artery the aneurysm is located but it is near the left ear and actually embedded in the brain. They are going to do an angiogram on him to see more detail about it because they are not sure if they can even operate on it as they think it might be too risky.


It would not be right on commenting the line of management without having the basic details.
Once you have the angiogram report; please share the report so that I can discuss the possible treatment options.
Regards.


Patient replied :

I have found out it's on the middle cerebral artery. If that is not enough information, he is going for an angiogram on Tuesday so they can get better detail of the aneurysm then. Is it possible for me to leave this question open for a few days until I have more details about it? I would appreciate it so much.


Hello,
Yes, I am the InHouse Physician and I will keep this consult open for one more follow-up.
Regards,
InHouse Physician.


Dr. Goutham Cugati
Category: Spine Surgeon
Experience: 
Residency: Neurosurgery, the Post-Graduate Institute of Neurological Surgery, Dr. Achanta Lakshmipathi Neuro surgical Center, VHS Hospital, Chennai, 2011

Postgraduate in Neurosugery: DNB, National Board of Examinations,
Part 1 - 2008, Part 2 -  2010

Medical School: Bachelor of Medicine, Bachelor of Surgery, JSS Medical College, 2004
Dr. Goutham Cugati and 4 other Medical Specialists are ready to help you

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