The Road to Recovery after Brain Aneurysm Treatment - Physical Effects

Having a brain aneurysm and undergoing treatment is a life changing event. Recovery is more difficult and longer in older patients, following brain aneurysm rupture and chronic medical problems. Patients recovering after treatment of brain aneurysm often have physical, emotional and psychological issues. Besides the patient, the family also suffers from many issues, one of the most important being financial burden in Indian scenario. In the coming few posts, I will discuss the issues faced by patients and family and how to get over them

Neurological

• weakness of arm, leg
• speech problems
• memory problems
• visual problems
• loss of smell or taste
• difficulty walking or balance problems
• seizures
• fatigue and generalized weakness
• sleep problems
• back pain

Many of these problems gradually improve over time. Evaluation by a physiotherapist and occupational therapist is recommended in patients with arm or leg weakness and balance problems. Speech therapy can help many patients with difficulty understanding and speaking. Appropriate neuropsychological testing and therapy can help patients with memory and behavioral problems to cope with the frustration. Some of the common memory problems include absorbing, storing and recalling information. The memory problem may be from the bleed or stroke during the acute period after aneurysm rupture. Organizing one's daily activities and writing down information is helpful.

Patients with visual problems and seizures should be careful not to drive and should avoid working near heavy machines that can cause injury. evaluation by an ophthalmologist is advised for visual rehabilitation.

Fatigue and generalized weakness is a common complaint in many patients. The patients should understand that it is normal to be sleepy and not interested in outdoor activities for a few weeks. The bleeding in the brain takes a few weeks to resolve. Eat well and engage your mind in activities to keep you busy. Trouble sleeping in the night is also very common and should get better with time.

Back pain may occur in some patients due to lying in the bed for many days or if the bleeding extended into the spine. The headache may also be from spinal tap in some patients. The pain usually resolves in a few weeks as the patients involve themselves in activities.

Common problems following surgery for brain aneurysms are

• incision site pain and numbness - may patients complain of local pain at the site of incision in the scalp following surgery. Some may have numbness over the incision site. The pain and numbness usually goes away with time.
• jaw pain - many patients may have jaw pain on the side of surgery, especially while eating or chewing hard food. For this reason, it is advisable to eat soft food immediately after the surgery. The jaw pain occurs due to manipulation of muscles during surgery and resolves slowly after surgery in about a month.
• clicking sound in the head - some patients may notice a click in the head following surgery. It is also a normal phenomenon and usually resolves in a few weeks
• headache - some patients may have intermittent mild headache that disturbs their daily activity. The pain usually resolves with pain pills or by itself. If headache is severe, associated with vomiting or blurring of vision, consult your doctor immediately.

Common problems following coiling or stenting for brain aneurysms are

• groin pain - there may be bruising or pain in the groin for a few days after the procedure. Please consult your doctor immediately if there is sudden bleeding from the puncture site or painful swelling.
• hair loss - is seen in some patients secondary to radiation. It is more common when the procedures last longer than about 3 hours. The hair loss is temporary in most of the patients.
• headache - may occur in some patients and is usually due to the bleed that occurred following aneurysm rupture. it resolves gradually on its own.
• general bruises over the body - may occur in some patients who take blood thinner pills following stenting. Try not to get hurt or cut yourself inadvertently. If you notice a bad bruise, contact your doctor immediately.