Aneurysm Clipping Pro or Con

Specialties Neurological

Published

  1. Would you consider a aneurysm clipping or take your chances?

    • 2
      Yes
    • 1
      No

3 members have participated

Specializes in Med-Surg - Neuro Science - Cardiac.

I would like to get feedback from other Neuro nurses who have taken care of patients that have had aneurysm clippings. I have had two patients over the last two weeks who had similar clippings and I have seen patients who were alert and oriented x 3, and now alert to person only and unable to care for themselves. They both have ended up with Peg tubes and will end up in skilled nursing care. These patients were viable adults prior to surgery and I am struggling to understand if other Neuro nurses have had similar results. One of the patients was slated for a VP shunt as she had fluid build up on the right side of her head but after several days of CT scans the fluid sac decreased and finally dissipated but the patient has remained somewhat lethargic and and disoriented. This is a woman who prior to surgery was walking to the bathroom and holding intelligent conversations. The other patient has been agitated and has slurred speech and on multiple assesement is not even oriented to person. He had some issues prior to surgery but was walking and talking and working a full time job.

I would appreciate any feed back from other nurses on their experience with this procedure.

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Specializes in LTC, Wounds, Med/Surg, Tele, Triage.

I am not a neuro nurse so cannot specifically answer your question. However, my mom had an cerebral aneurysm clipped (clamped) in 2009, behind her right eye. She came through ok. It was very scary...not knowing if she would come out of surgery the same way she went it. Some pain on that side but the neurologist said that's normal.

We decided not to take our chances with it because it was pretty big, and I wouldn't want it to just break, say if she was driving or something like that.

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Specializes in Med-Surg - Neuro Science - Cardiac.

Thanks mudd68, glad to hear all is well with your mom. This is a procedure we are now seeing done again after many years of neurosurgeons declining to do so. Thanks for the feedback. :nurse:

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Specializes in ICU.

Decline or loss of function is a known possible outcome of any brain surgery. The alternative is to do nothing and walk around with a ticking time bomb in your brain. When the aneurysm bursts, it can cause even greater loss of function or death. I have seen many, many aneurysm clippings go extremely well with little to no negative side effects, but the risk is always there.

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Decline or loss of function is a known possible outcome of any brain surgery. The alternative is to do nothing and walk around with a ticking time bomb in your brain. When the aneurysm bursts, it can cause even greater loss of function or death. I have seen many, many aneurysm clippings go extremely well with little to no negative side effects, but the risk is always there.

Was the OP patitents clipped without having a sah bleed or had they had a non bleeding aneryual(picked up on a ct). My ward cares for aneryual sah and cold coiled aneryuam . I have never seen deficits from cold coiled anyersums. However sah can make very bad recovery even from hunt-hess grade 1, post coil or clipping. It very sad but without treatment they would die.

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Specializes in Pediatric Cardiology.

I work on a post-surgical floor and our main population is neurosurgery so I see this surgery done quite often. We do clippings and coilings. To be honest, I haven't experienced any of what you describe. The biggest problem we see is the formation of a hematoma at the groin site and even that's rare. All my patients go in A&Ox3 and come out A&Ox3, sometimes they'll have a HA post-op.

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Maybe they went into vaso spasm?

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Maybe they went into vaso spasm?

Oh I hate vasospasm

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Specializes in Pediatric Cardiology.
Oh I hate vasospasm

Oh yes, vasospasm! I forgot about those. We actually just got a patient who spent 22 days in the ICU for that exact reason. She is neurologically intact, could have gone the other way though I guess.

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When family ask me the plan for a SAH I go over the norms tha t our doctors have Already said but I also say this is if everything goes smoothly. Our patio tsunami get told to listen to that nurses as we know exactly what to go. Any patient without a tracehy or peg is good

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Specializes in Neuro ICU and Med Surg.

Sometimes the pts go into vasospasam. After some time they get better. There is risk of vasospasam with coiling and clipping. Sometimes the resulting vasospasam causes a rebleed or a stroke.

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