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Patient Instructions

You had a brain aneurysm. An aneurysm is a weak area in the wall of a blood vessel that bulges or balloons out. Once it reaches a certain size, it has a high risk of bursting. It can leak blood and cause a stroke or bleeding along the surface of the brain (also called a subarachnoid hemorrhage).

You may have had surgery to prevent bleeding or to treat the aneurysm after it bled. The two types of surgery are:

• Open craniotomy (a hole is made in your skull to place a clip)
• Endovascular repair (the doctor can do surgery on areas of your body through a blood vessel).

If you had bleeding before, during, or after surgery you may have some short- or long-term neurological problems. These may be mild or severe. For many people, these problems will decrease over time or go away.

If you had either type of surgery you may:

• Feel sad, angry, or very nervous. This is normal.
• Have had a seizure and will take medicine to prevent another one.
• Have headaches that may continue for a while. This is common.

What to expect after craniotomy and placement of a clip:

• It will take 3 to 6 weeks to fully recover. If you had bleeding from your aneurysm this may take longer. You may feel tired for up to 12 or more weeks.
• Problems with your memory are common, but these may improve.
• You may feel dizzy or confused, or your speech may not be normal after the surgery. If you did not have any bleeding, these problems should get better or go away soon.

See also: Brain surgery (craniotomy) - discharge

What to expect after endovascular repair:

• You may have pain in your groin area.
• You may have some bruising around and below the incision.

You may be able to start daily activities, such as driving a car, within 1 or 2 weeks if you did not have any bleeding. Ask your doctor for advice.

Make plans to have help at home while you recover.

Follow a healthy lifestyle. If you have high blood pressure, keep it under control. Do not smoke. If you drink alcohol, talk with your doctor about when it is okay to start again. Ask your doctor when it is okay to start sexual activity.

Take your seizure medicine if any was prescribed for you. Your doctor may refer you to a speech, physical, or occupational therapist to help you recover from any brain damage.

If the doctor put a catheter in through your groin (endovascular surgery), it is okay to walk short distances on a flat surface. Limit going up and down stairs to around 2 times a day for 2 to 3 days. Do not do yard work, drive, or play sports for at least 2 days -- or when your doctor says it is okay to do so.

Your doctor or nurse will tell you when your dressing should be changed. Do not take a bath or swim for 1 week. If you have bleeding, lie down and put pressure on the incision site for 30 minutes.

Call your doctor if you have:

• A severe headache or a headache that gets worse and you feel dizzy
• A stiff neck
• Nausea and vomiting
• Eye pain
• Problems with your eyesight (from blindness to peripheral vision problems to double vision)
• Speech problems
• Problems thinking or understanding
• Problems noticing things around you
• Changes in your behavior
• Feel weak or lose consciousness
• Loss of balance or coordination or loss of muscle use
• Weakness or numbness of an arm, leg, or your face.

Also, call your doctor if you have:

• Bleeding at the incision site that does not go away after you apply pressure
• An arm or leg that changes color, becomes cool to touch, or becomes numb
• Redness, pain, or yellow or green discharge in or around the incision site
• A fever higher than 101 degrees °F or chills

Aneurysm repair - cerebral - discharge; Cerebral aneurysm repair - discharge; Coiling - discharge; Saccular aneurysm repair - discharge; Berry aneurysm repair - discharge; Fusiform aneurysm repair - discharge; Dissecting aneurysm repair - discharge; Endovascular aneurysm repair - discharge

Bashir Q, Badruddin A, Aletich V. Endovascular techniques for stroke prevention. Nuerol Clinic. 2008 Nov;26(4): 1099-127.

Patterson JT, Hanbali F, Franklin RL, Nauta HJW. Neurosurgey. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 72.

Updated by: Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.