After Your Treatment
You can expect some changes in the first few days and weeks following your treatment. Which of these you experience and how long they last depends on a number of factors, including whether your aneurysm had ruptured prior to treatment and the type of treatment (open or endovascularWithin the blood vessels/vascular system.) you had.
After Open Surgery
Issues after open surgery (clippingThe surgical method for treating an aneurysm. The surgeon exposes the aneurysm with a craniotomy and places a metal clip across the base of the aneurysm so that blood cannot enter it.) may include:
The pain usually occurs at the incision site. It may take several weeks for the incision to heal. After this time, you may experience brief episodes of sharp pain in the incision area as the nerves grow back. This is not cause for concern. The pain will go away with time. The incision area can also feel numb; this may or may not get better with time. It may be uncomfortable to sleep on the side with the incision, but it is safe to do so.
You may notice muffled hearing in the ear on the same side as the incision. This is due to fluid accumulation and will get better with time. However, it may take several weeks to notice improvement.
Jaw pain may occur when you open your mouth to eat or brush your teeth. This is due to manipulation of the muscles during surgery. The pain will improve over time. You may be able to speed up your recovery by opening and closing your mouth (about 10 times) at least four to five times a day, gradually increasing how wide you open it. Let your surgeon know if the pain persists after six weeks; in this case, physical therapy may be advised.
Clicking Noise in Head
This commonly occurs when you position your head in different ways. While alarming, there is no need to be concerned. This is the bone healing and a normal part of the recovery process. The clicking goes away after several weeks.
Seizures may occur at the time of aneurysm rupture or sometimes as a result of surgery on certain parts of the brain. Your neurosurgeon may put you on an anti-seizure medication in the hospital. In certain cases your doctor will have you continue this medicine after you go home. If there are no further seizures, the medicine is usually continued for only a short time. If you are on anti-seizure medicine, it is important that you take the medicine as prescribed.
After Endovascular Treatment
Issues after endovascular treatment (also called embolizationA technique performed by a neuroradiologist or a neurosurgeon in the treatment of brain aneurysms or brain AVMs. As an extension of an angiogram, a catheter is passed up into the arteries inside the brain into the arteries supplying blood flow to the AVM or inside an aneurysm. The blood vessel or aneurysm is then blocked off from the inside with either glue, metal coils or other substances. This is often performed as a prelude to surgery in brain AVMs, but occasionally may be curative without additional therapy.) may include:
There may be bruising and discomfort where the catheterA flexible tube for insertion into a vessel, body cavity, or duct; used for an angiogram of the brain arteries and in the endovascular treatment of brain aneurysms to provide access to the aneurysm site. was inserted in the groin. You should avoid strenuous activity and hot baths for one week after treatment. A hematoma (hard large blood clot) can develop at the site. Should this happen, or if there is increased pain or swelling in the area, contact the doctor who performed the procedure.
Radiation or the contrast dye used during the procedure can occasionally result in hair loss. This usually only affects a small area and is temporary — the hair will grow back. Keep in mind that stress and medicines can also cause temporary hair loss.
Fatigue is the most common problem in the recovery process. You may feel tired all the time and have no energy or “get up and go.” Normal everyday activities, even simple ones such as taking a shower, may wear you out. You may take more naps, only to find that you have trouble sleeping at night.
This is normal. Keep in mind your body has been through a lot and needs rest before it can function well again. As time goes on, gradually increase your activities and the amount of time you spend doing them. It can take months before your activity level returns to where it was before your treatment. Try not to get discouraged, and take it one day at a time.
If you frequently have trouble sleeping, talk with your healthcare provider. Sometimes the short-term use of a sleeping medication may be helpful.
Also, have your family limit your visitors. Visitors mean well but can wear you out. If they want to help, suggest they prepare a meal or do shopping for you.
Diminished Sense of Smell and/or Taste
Survivors often report changes in their ability to taste and/or smell. If the aneurysm ruptured, smell and taste deficits can be caused by blood that irritates the nerves that control these senses. If the aneurysm did not rupture, smell and taste deficits can occur if the aneurysm compresses the surrounding nerves. Unfortunately, these deficits may not get better with time.
Many patients experience headaches. Headaches are usually more of a problem for those whose aneurysm ruptured. The headaches can vary in intensity from day to day, and last for several weeks or longer. Please note that some aneurysm patients have a long history of headaches. These headaches will not be cured by treatment of the aneurysm, as they are not related. The headaches may seem to go away for a while but unfortunately usually return.
Headaches can be frightening, particularly if you had an aneurysm rupture. Keep in mind that the likelihood that a treated aneurysm will rupture is almost zero. Headaches due to aneurysm rupture are not only severe, but sudden. Call 911 in the rare case that a severe and sudden headache occurs.
In general, prescription pain medications may be needed for the first couple of weeks after your treatment. You should switch to over-the-counter pain medications, such as Tylenol, as soon as possible. If headaches are not eased by pain medications — or if the headaches continue even after several weeks — notify your doctor.
Some people have specific problems with vision due to the location of the aneurysm. Others have problems with focusing or blurry vision as a result of subarachnoid hemorrhage. Problems with focus and blurred vision are common and tend to improve over time. If vision problems do not improve, contact your doctor. Consultation with a neuro-ophthalmologist might be helpful.
Low Back Pain
Some people experience low back pain and/or shooting pain down the back of the leg. If the aneurysm ruptured, your back pain may be caused by blood in your spinal fluid that is irritating the nerves. This will get better with time. Low back pain can also be due to lying in bed for many days and lack of activity. This type of back pain usually gets better as you increase your activity level, but may require physical therapy. Gentle stretching or a heating pad may help relieve the pain. Notify your healthcare provider if low back pain persists.
Constipation is common and may be due to inactivity and/or a diet low in fiber or fluids. The major cause of constipation after aneurysm treatment is the use of narcotic medications. Constipation usually improves with increased activity and decreased use of pain medications. Stool softeners like Colace can be helpful, as are mild laxatives such as Metamucil. Avoid straining when having a bowel movement.
Slowed Reaction Times
In most people, reaction time is slower during recovery for at least some period of time. It is not safe to drive under these circumstances. Follow your doctor’s advice as to when you can resume driving. If you have memory/cognition, visual, or certain other physical problems, you should not attempt to drive. The Department of Motor Vehicles provides testing to determine whether/when you can return to driving.