Post Treatment and Outcome
The recovery following treatment of an intracranial aneurysm is dependent on many factors, including whether the aneurysm has bled and the type of treatment for the aneurysm.
If an aneurysm presents with a subarachnoid hemorrhage, the length of hospitalization and recovery are dictated by the severity of the hemorrhage and not by the treatment modality. Following a subarachnoid hemorrhage, most patients will remain hospitalized for a minimum of two weeks during which time they will be monitored for the development of cerebral vasospasm and other complications of the hemorrhage including hydrocephalus. If the patient develops any of these complications or has a neurological deficit from the initial hemorrhage, variable periods of rehabilitation on an inpatient or outpatient basis may be necessary. Under the best of circumstances many patients may resume all of their previous activities within a period of several weeks without any specific limitations on their activities.
For patients with unruptured aneurysms, the hospitalization and recovery is typically much smoother and more predictable. In this case, the modality of treatment does influence the hospitalization and recovery. Endovascular therapy, being less invasive, is associated with a shorter hospitalization and more rapid return to previous activities. Following a successful endovascular procedure, most patients are observed in the intensive care unit overnight and discharged from the hospital the following day if there are no complications. These patients may resume all of their prior activities without any specific restrictions within a matter of days. This includes going back to work, driving and flying in airplanes.
Following a craniotomy for clip ligation of an aneurysm, most patients will spend a night in the intensive care unit and be moved out to a private room the following day. Typically, patients are discharged from the hospital a couple of days after discharge from the intensive care unit able to perform all the activities of daily living. It generally takes 4 to 6 weeks to recover from any major operation including a craniotomy for aneurysm. During this time the patient is able to care for themselves, but typically does not engage in aggressive physical activity. Patients are usually able to a care for themselves and stay alone with gradually increasing activity including walking, household chores and work that does not involve significant physical exertion. After approximately 4 to 6 weeks these activities are liberalized and patients are encouraged to resume all of their previous activities without any specific restrictions. It is by increasing activity at this time that patients more quickly resume their strength and endurance.
Because of the higher risk of recurrence of aneurysms following endovascular therapy, some routine maintenance is required and patients will typically return to their physician for follow-up angiography at variable periods of time to monitor for any evidence of recurrence. Following surgical clip ligation of the aneurysm, there typically is no routine maintenance of the aneurysm, particularly if intraoperative imaging documented complete obliteration of the aneurysm. For younger patients or those with a strong family history of aneurysms who may be at higher risk of the development of de novo aneurysms some routine monitoring may be recommended.