Clipping is a common surgical treatment for brain aneurysms. It is an effective, well researched surgical procedure with excellent results. The goal of clipping is to place a small metallic clip or clips along the neck of the aneurysm. This prevents blood from entering into the aneurysm sac so that it can no longer pose a risk for bleeding. Once an aneurysm is clipped, the clip remains in place for life. The aneurysm will shrink and scar down permanently after clipping.
For the aneurysm clipping procedure, the patient is put under general anesthesia, and then prepped for surgery. The head is stabilized to make sure it does not move during the surgical procedure. Depending upon the location of the aneurysm, an incision is typically made behind the hairline or on the back of the head. A small portion of the hair is usually shaved along the line of the incision. Next, a section of the skull bone is removed from the skull using a specialized bone drill. This gives access to the lining over the brain called the dura. The dura is then opened to expose the brain surface. The surgeon approaches the aneurysm in the cleft between the skull and the brain and not through brain tissue. Under a microscope, the aneurysm is then carefully separated from the normal blood vessels and brain.
Once it has been fully exposed, the aneurysm is then completely obliterated with a tiny metal clip, something like a tiny clothespin. This keeps blood from entering the aneurysm. As a result, future bleeding is prevented and nearby brain tissue is protected from further damage. The bone plate is then put securely into place, using thin metal plates and screws, and the wound is closed. These bone plates are MR compatible and remain in place permanently, although the skull bone will heal together over 6 – 12 months. The great majority of aneurysm clips are also MR compatible but you should check with your surgeon prior to having an MRI.