Patient Expectations

It is common to feel anxious and uncertain before treatment; but our team of physicians will be on hand to meet with you and your family to address all concerns.

The Center is devoted to maintaining an environment of clear, consistent communication. We achieve this by ensuring that you and your family's questions have been answered and that everyone understands all treatment recommendations and procedures.

The Center's family care conferences and support groups encourage this continuous communication. Our specialists work to provide you and your family with information and emotional support before and after treatment. Our physicians will explain everything thoroughly before moving forward.

Admission

The sooner we make clear the treatment options that are available to you, the sooner we can act. In the case of a non-emergency or elective surgery, you and your family will be given a thorough explanation of your treatment options and chosen recommendations. This consultation will be conducted during an interview session one to two days prior to admittance.

Some procedures will demand preparation, such as: no eating or drinking for a specified amount of time before surgery, while others require little to no planning.

In the case of an emergency, you will have limited options. If you begin to experience symptoms of a ruptured aneurysm, CALL 911. We do not encourage you to allow a family member to take you in a private vehicle to the hospital. This is a high stress situation that may require the paramedics to execute lifesaving procedures in the emergency vehicle.

Our neurologists work closely with the Emergency Medical Services (EMS); and the Center's staff will promptly meet with EMS upon your arrival at the hospital. If you are outside of the Minneapolis/St. Paul area when an emergency occurs, tell your EMS driver to go to the closest certified primary stroke center.

Treatment

Once the status of your neurological condition has been evaluated, you will be provided with information on your treatment plan. The severity and location of your brain aneurysm will determine whether a neurovascular expert advises observation or surgery. The neurologist or family practitioner you normally see may refer you to a neurosurgeon.

Questions to ask the surgeon:

How many surgeries do you perform a year?
What are your outcome statistics?
Do you specialize in only brain aneurysms?

A neurosurgeon who performs only a dozen brain aneurysm surgeries a year does not have the same level of experience as one who performs 150 aneurysm operations a year. Be your own advocate and ask questions.

Observation

Observation is when no direct action is taken. Your surgeon considers it safer to monitor the unruptured aneurysm than it is to attempt other invasive procedures. The neurologist or surgeon may suggest following-up with an MRA (magnetic resonance angiography used to detect suspected aneurysms) or a CTA scan (special x-ray used to detect a ruptured aneurysm) from six months to one year after the initial diagnosis to observe any changes in the aneurysm's growth. Observation is rarely an option once the aneurysm has ruptured. There is a high risk of a ruptured aneurysm to rebleed, so patients usually undergo surgical treatment.

Surgery

Surgical treatment procedures for aneurysms include clipping and coiling. Determining which of these options to pursue should be decided mutually between you and your physician. Keeping in mind that aneurysm surgery carries potential risks, our team will make recommendations based on a complete evaluation of your condition.

Clipping

The neurosurgeon opens the skull and delicately separates the aneurysm from the surrounding tissue. A small titanium clip, which opens and closes like a clothespin, is then placed across the base of the aneurysm. Once the clip is secured, blood can no longer flow in or out of the aneurysm sac. By using a needle to drain the remaining blood out of the aneurysm, the sac should empty and eventually collapse. When the blood flow is preserved through the main artery, the aneurysm is not likely to return. To ensure accuracy, an angiogram is performed, where a tiny camera takes an X-Ray picture of the surgical area. This tells the surgeon that the aneurysm has been completely clipped without hitting any nerves or other arteries.

Coiling

Also known as endovascular therapy, coiling is an innovative, less invasive surgical treatment option. This procedure does not involve craniotomy (the opening of the skull), and is performed from inside the blood vessel. A catheter is inserted into the patient's groin area and is guided up toward the brain. A fine wire is then threaded into the catheter and directed into the aneurysm. Once inside the aneurysm, the wire twists into small coils and continues filling the aneurysm sac until it eventually clots off.

Recovery

What to expect

Your successful recovery is our primary concern. The process will vary depending on the circumstances of your condition. The overall length of stay may be from one to four weeks following surgery.

The length of your hospital stay will depend on:

The size and type of the aneurysm
Whether the aneurysm ruptured or remained unruptured
Where the aneurysm was located in the brain
The treatment procedure that was performed

Most patients will initially recover for the first few days in the neurointensive care unit (neuro-ICU) at St. Joseph's Hospital. Once the patient is transferred from the neuro-ICU, the Center's physicians will closely monitor the pressure levels of the brain to evaluate if there are any complications or bleeding. If all is well, no further rehabilitation may be needed.

Factors that influence recovery may also include: your health status before the procedure, as well as your physical and emotional response after treatment.

After recovery: Patient follow-up

A patient's follow-up, on a local and national level, will be facilitated through ongoing communication between the local physicians and the Center. This collaborative approach is organized to continually assess patient needs as they surface.

Support groups and resources

Brain Aneurysm Support Group

Our monthly Brain Aneurysm Support Group offers information and support for those dealing with a brain aneurysm. The group meets the fourth Thursday of each month at St. Joseph's Hospital.

Click for dates and times.

East Metro Stroke Education Series

The National Brain Aneurysm Center and the Minnesota Stroke Association sponsor a monthly education series for stroke survivors and their care partners. Classes are held the third Wednesday of each month at Woodwinds Health Campus.

Click for dates and times.

Stroke Support Group

Our monthly Stroke Support Group offers information and support and is open to stroke survivors, caregivers, spouses and significant others. The group meets the first Thursday of each month at St. Joseph's Hospital.

Click for dates and times.

Young Adult Support Group Now Forming

Almost 30% of people who experience stroke are under the age of 65. Young adults' needs vary from parenting, school, and work to activities, sports and socializing.

Join us in a warm and welcoming environment as we discuss challenges, frustrations, positive changes, rehab, barriers and problem solving.

Methodist Hospital
Heart & Vascular Center in HVC-B
6500 Excelsior Blvd.
St. Louis Park, MN 55426

For more information contact Karen at 952-993-6789; Karen.bjorgan@parknicollet.com

Related web site

The Brain Aneurysm Foundation - Provides support networks and educational resources to raise public awareness regarding early detection and treatment of brain aneurysms.