Microvascular clipping (MC) is surgery to cut off blood flow to a brain aneurysm. This is done to try to stop bleeding and rupture. This is a complex, open surgery.
Reasons for Procedure
MC prevents a brain aneurysm from causing more harm. It is done to make your quality of life better.
An aneurysm is a weakened blood vessel in the brain that collects blood. The bulging, blood-filled pocket can put pressure on parts of the brain, pressing on nearby nerves. This can cause symptoms or cause the blood vessel to rupture (hemorrhage).
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Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems such as:
- Numbness or tingling
- Speech problems
- Visual changes
- Confusion, memory loss
- Reaction to anesthesia
- Kidney damage
- Blood clots
- Ruptured aneurysm
Your chances of problems are higher for:
What to Expect
Prior to Procedure
If your surgery is not an emergency, your doctor may do:
Leading up to the procedure:
- Talk to your doctor about the medicines you take. You may need to stop them up to 1 week in advance.
- Don’t eat or drink after midnight the night before.
- Women should let their doctor know if they are pregnant or planning to become pregnant.
General anesthesia will block pain and keep you asleep.
Description of the Procedure
The technician will cut the hair off of the site on your head.
A small section of the skull will be removed to access the brain. The blood vessel will be found using imaging tools. The aneurysm will be removed from nearby healthy tissue. A clip will be placed to clamp the artery and separate it from the bloodstream. The clip will stay in place to prevent bleeding and rupture in the future.
The skull will be returned. The scalp will be stitched back into place.
Immediately After Procedure
You will stay in a care unit for about a day. You may be given medicine for pain or other problems.
How Long Will It Take?
3-5 hours, maybe more
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Medicines will ease pain after.
Average Hospital Stay
MC is done in a hospital. You will stay there for 4-6 days. If you have problems, you may need to stay longer.
At the Hospital
- You will lie still for 6-8 hours.
- Nurses will check your vital signs.
During your stay, the healthcare staff will take steps to lower your chances of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered.
There are also steps you can take to lower your chance of infection such as:
- Washing your hands often and reminding your healthcare staff to do the same
- Reminding your healthcare staff to wear gloves or masks
- Not allowing others to touch your incision
When you get home, you may have to make changes while you get better. This may take 3-6 weeks. This may mean:
- Resting when you need to
- Caring for the wound
- Physical or rehabilitative therapy
Call Your Doctor
Call your doctor if any of these occur:
- Changes in balance, strength, or movement
- Changes in mental state
- Weakness, numbness, or tingling
- Fever or chills
- Redness, swelling, pain, bleeding, or pus from the wound
- Vision problems
- Pain that you cannot control with the medicines you were given
- Nausea or vomiting
- Bladder or bowel problems
- Pain, swelling, or cramping in your legs
Call for emergency medical services right away for:
- Breathing problems
- Chest pain
If you think you have an emergency, call for emergency medical services right away.
Brain Aneurysm Foundation
National Institute of Neurological Disorders and Stroke
Brain Injury Canada
Heart and Stroke Foundation
Cerebral aneurysm. American Association of Neurological Surgeons website. Available at: http://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Cerebral-Aneurysm. Accessed July 18, 2018.
Cerebral aneurysms fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Cerebral-Aneurysms-Fact-Sheet. Updated July 6, 2018. Accessed July 18, 2018.
Subarachnoid hemorrhage. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116453/Subarachnoid-hemorrhage. Updated June 6, 2018. Accessed July 18, 2018.
Treatment of brain aneurysm. The Aneurysm and AVM Foundation website. Available at: http://www.taafonline.org/conditions/aneurysm/treatment. Accessed July 18, 2018.
Williams LN, Brown RD Jr. Management of unruptured aneurysms. Neurol Clin Pract. 2013;3(2):99-108.
Last reviewed May 2018 by EBSCO Medical Review Board Michael Fucci, DO, FACC Last Updated: 7/18/2018