Microvascular clipping is a surgery to cut off blood flow to an
. This prevents bleeding and rupture. Typically, a portion of the skull is removed (a procedure called a
) and restored during this complex, open surgery.
Microvascular clipping treats a
. It will not fix already damaged areas of the brain, but it can improve quality of life by stopping bleeding or preventing rupture.
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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If you having this procedure, your doctor will review a list of possible complications, which may include: WeaknessNumbness or tinglingSpeech disturbancesVisual changesConfusion, memory lossSeizuresInfectionReaction to anesthesia (eg, light-headedness, low blood pressure, wheezing)Kidney damage
Blood clots (eg,
Ruptured aneurysm during surgery
Factors that may increase the risk of complications include: SmokingObesityHigh blood pressure
Discuss these risks with your doctor before surgery.
Your appointment before the surgery may include: Physical exam, blood and imaging testsDiscussion of allergiesDiscussion of medicines you are taking, including over-the-counter and herbal supplementsDiscussion of recent illness or other conditionsDiscussion of risks and benefits of treatment options
Women should let their doctor know if they are pregnant or planning to become pregnant.
You will meet the neurosurgeon performing the procedure.
Imaging tests (ultrasound,
, angiogram) may be done before the procedure. Bring paperwork and scans to the hospital as directed.
Arrange for a ride home.Fasting—No food or drink after midnight the night before the procedure.
Discuss your medicines with your doctor. You may be asked to stop taking certain medicines before your procedure. Common medicines to stop include
, nonsteroidal anti-inflammatory drugs (NSAIDs), or blood thinners.
will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV (needle) in your hand or arm.
In the operating room, the nurses and doctors will connect you to monitors to watch your blood pressure, heart rate, and pulse. A catheter will be inserted to collect urine during surgery. An IV will be placed in your arm for sedation and anesthesia. The nurse will cut the hair off an area of your head for surgery.
The doctor will perform a craniotomy, removing a small section of the skull to access the brain. X-rays and microscopic viewing may help the doctor find the exact weakened area of the blood vessel. The aneurysm will be separated from nearby healthy brain tissue. The doctor will then place a small titanium clip at the neck of the aneurysm, stopping blood from flowing. The clip will stay in place to permanently prevent bleeding and/or rupture.
The section of skull will be replaced, and the scalp will be stitched back into place.
When the procedure is done, the catheter and IV line will be removed. You will need to lie still for 6-8 hours or more. You will stay in the ICU for about a day. Your blood pressure and other vitals will be monitored closely. You may be given medicine.
You may feel a pinch when your IV is inserted for anesthesia. Anesthesia prevents pain during surgery. Pain or soreness after the procedure can be managed with pain medicine.
The surgery is done in a hospital setting. The usual length of stay is 4-6 days. Your doctor may choose to keep you longer if complications arise.
You will rest for several hours.Nurses will monitor your vital signs.
It will take at least 3-6 weeks to recover. When you return home, do the following to help ensure a smooth recovery:
Rest often.Keep blood pressure under control.Cleanse the incision site as directed. Use a soft wash cloth to gently wipe the incision area and keep dry.Take medicine as directed.Engage in rehabilitative therapy as directed.Ask your doctor about when it is safe to shower, bathe, or soak in water.
Be sure to follow all of your doctor’s
After you leave the hospital, contact your doctor if any of the following occurs: Any changes in physical ability—balance, strength, or movementAny changes to mental status—level of consciousness, memory, thinking, or responsivenessWeakness, numbness, tinglingSigns of infection, including fever and chillsRedness, swelling, increasing pain, a lot of bleeding, or any discharge from the incision siteHeadache that does not go awayChanges in visionFaintingPain that you cannot control with the medicines you have been givenNausea and/or vomiting that you cannot control with the medicines you were given, or that continue for more than two days after leaving the hospitalTrouble controlling your bladder and/or bowels
Call for medical help or go to the emergency room right away if any of the following occurs: SeizureShortness of breath, or chest painLoss of consciousness
If you think you have an emergency, call for medical help right away.
Last reviewed June 2013 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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