DECEMBER 2014
|
The Surgical Technologist
|
549
brain imaging obtained
for other conditions. If
imaging reveals a sub-
arachnoid hemorrhage,
more testing is conduct-
ed to confirm the diag-
nosis of an aneurysm.
Ac cord i ng to t he
National Institute of
Neurological Disorders
and Stroke (2013), there
are several diagnostic
methods to help deter-
mine the best form of
treatment. Four of the
most common methods
are the angiogram, the
CT scan, magnetic reso-
nance imaging (MRI)
and magnetic resonance
angiography (MRA). The
angiography dye test, or
angiogram, is used to
analyze arteries or veins.
It can detect the degree
of narrowing or obstruc-
tion of a blood vessel in
the brain, head or neck.
An angiogram also can
identify changes in an
artery or vein, detecting weak spots such as aneurysms. The
CT scan is often the first diagnostic procedure ordered by a
physician following a suspected rupture. It is a quick, pain-
less, noninvasive diagnostic tool that reveals the presence of
an aneurysm. If an aneurysm has ruptured, a CT scan will
determine whether blood has leaked into the brain. The MRI
uses computer-generated radio waves and a powerful mag-
netic field to produce detailed images of the brain.
7
T R E A T M E N T
As previously mentioned, unruptured aneurysms can go
unnoticed throughout a person’s lifetime; a ruptured aneu-
rysm, however, can be fatal or could lead to a hemorrhagic
stroke, vasospasm (the leading cause of disability or death
following a ruptured aneurysm), hydrocephalus, coma, or
short-term and/or permanent brain damage. If it is deter-
mined that an aneurysm requires surgical invention,
there are two options. The first is endovascular coiling of
an aneurysm, which is performed as an extension of an
angiogram. The second intervention, and the one that will
be examined in this article, is open surgical clipping of the
aneurysm.
P R E - O P
A routine preoperative checklist includes: history and
physical, labs HCG (females), EKG and placement of IV.
Anesthesia, surgical and blood consents are verified by the
anesthesiologist and a registered nurse. The patient and
their family are then asked if they have more questions and
concerns before being transported to the operating room.
