Clipping Recovery Roadmap

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Hi friends - noob here. In February, I was diagnosed with an incidental unruptured 7mm “windsock” aneurysm at the bifurcation of the right MCA via MRA and DSA. Due to the close proximity of the ATA origin to my aneurysm, endovascular interventions like coiling, stents & WEB have potential for blocking the branch and causing issues down the line. As such, I’m scheduled for clipping at UCLA Health on 6/4.

I’m a 46 year old non-smoker with no blood pressure issues nor family history of aneurysms (that I know about). I also live very high octane lifestyle with lots of exercise and a stressful (but gratifying) job. Upon first diagnosis, I spiralled hard for a couple weeks, but I’ve gradually arrived at a place of gratitude and acceptance. Now I just want to get surgery over with so I can close this crappy chapter.

I have a few questions about recovery:

  1. I’ve heard nightmares about Keppra and its psychiatric effects, so I’ve been looking into Briviact as an alternative. Any experience or other suggestions?
  2. I’m super prone to throwing up after anesthesia and surgery. Any meds or remedies to share?
  3. On a scale from 1-10, 10 being the worst pain of your life, what was your pain level right after the clipping and how quickly did it subside? What was the pain profile? (I know this is subjective, so tell me your experience)
  4. If you’ve had an unruptured clipping, what are some things about recovery that you didn’t expect going into it? Any tips for advocating for myself during the hospital stay or upon discharge?

I’m so grateful that a forum like this exists and appreciate any help/insights. :slight_smile:

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Welcome Matt! Thank you for starting a new topic and stumping me! I’ve never heard of a windsock type aneurysm in the brain and it very well may be too early for me to figure out how to get past AI. Despite putting in cerebral aneurysm, I keep getting info on the heart, go figure… If you don’t mind, can you explain it to us?

I can’t help you with any craniotomy questions as I’ve never had one. My surgeon told us I wasn’t a candidate for one and it would be a last ditch effort. My aneurysm is up at the LICA bifurcation and eventually she installed a Neuroform atlas stent that seems to be working decently. We will have to wait for those who have to come. It can take a bit of time due to countries and time zones, please be patient.

Medication side effects can be different for everyone as we are not the same. My old neurologist tried me on all kinds of epilepsy medication soon after I ruptured for a tremor I developed and I couldn’t take any of them. One thing you might try is talking to your pharmacist as they know medications better than our specialists in my experience. A lot of times specialists want to sue the meds they are familiar with so ask your surgeon.

I always chuckle when one of the folks I see asks what my pain level is as I always tell them my experience is based on my rupture which got the 10. I have to explain that to everyone who isn’t affiliated with my neurosurgeon and sometimes with whomever her CMA is, they change a lot. For many years, I stuck with 7 seems I liked that number and no other.:rofl:. I remember my Mom telling her cardiologist RNs in ICU her pain was 9 and then heard them discussing that couldn’t be since she’d had 4 children. Well, I was her baby and was in my 50’s at the time so had a few strong stuttering words to impart. I’m glad you realize pain is subjective, kudos!

Advocating for oneself is the same whether a craniotomy or endovascular procedure. Ask questions. Always have a list prepared for your doctor. A good way of asking is through your portal so they know ahead of time and either they or more likely a PA or NP or even an RN will answer. Do not and that should be DO NOT nod your head in agreement as if you understand them when you don’t. Doctors use medical jargon and unless you’re a medical specialist or some affiliated position, chance are you don’t understand a thing they say. If you’re in that position, ask them to dumb it down for you. I had taken some classes in college that gave me a background in the brain so I could follow along but BH had no clue being in custom metal sales. I just asked my neurosurgeon to explain it like I was a kindergartner. She laughed and said that was doable. We, as the human race have a bad habit of nodding our heads as a sign we’re listening and understanding but it does us no good. The specialist will think you get it when what they’re sounding like is someone from another planet. If you need to stop them for an explanation don’t be shy. Some doctors I have seen for other things have not appreciated me interrupting them or even questioning them. I found out later this is part of what’s called medical gaslighting. Don’t let them get away with it, you need to be heard, respected and understood. From what I’ve read when I looked it up, it occurs mostly with female patients but can happen to men as well. Do take someone you trust with you because people hear things differently. Make sure the notes they put down in your chart is the same as what they explained. If not ask why.

I know I sound like a broken record, but ask your surgeon about proper hydration and protein intake to help with healing. Learn relaxation breathing if you don’t know how, if you do, especially with a stressful job, practice it religiously as it will help more than I have words for.

Keep coming back and asking questions here, or on any other topic.

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Hello @goodsouldept -

I am sorry to hear that about your diagnosis! I can imagine that was not an easy diagnosis to hear, but it’s great that clipping is coming up so soon, and I am sure it will be over before you know it.

Like @Moltroub, I am from the “other” side of the family in that I had an unknown aneurysm that ruptured.* My repairs were endovascular, so I have not had any clippings, although I have had a couple of VP shunts, so I did have some experience with more “traditional” brain surgery (shaved head, etc., etc.)

After my experiences, one of my wishes for our healthcare system is that you would get discharge instructions BEFORE your surgery so you have a better idea what to expect and how to prepare while you still can (e.g., you can’t bend for 5 days, have enough food for a week, etc.). Even though I never had a clipping, I wondered if this Oxford University Hospitals (UK) guide on what to expect after cranial surgery may be of interest to you.

It discusses the different types of headaches you can get after cranial surgery, and I also like “Linda’s helpful tips.” (former patient).

During one of my VP shunts, I did throw up after surgery. The anesthesiologist did warn me in advance that it might happen, so it wasn’t really too much of a surprise that I actually did: the doctor knew what he was talking about. :joy: Going into subsequent procedures, I typically mention it to the anesthesiologist and say, yeah, that happened, and I point to which surgery it was (so they can look up what I was given). It has not happened since, so they seem to avoid using that one again. I am sure you have already taken a look over, but I just found this UCLA flyer with tips on how to deal with PONV. Betting you know them all, but just to be 100% sure!

I am sorry I can’t offer much experience with clipping recovery, but I am sure that those who can will be chiming in soon.

Wishing you all the best!

Fin Whale Fan :whale:

*My cat was just staring at me, so I take it he was saying hello and wishing you well! :cat_face:

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26 April 2026 newest members!
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Hi! Thank you both for your thoughtful replies.

“Windsock” refers to the morphology - it’s essentially a berry-shaped aneurysm with a wider neck, so it looks more like one of those windsocks you see at airports that show which direction the wind is blowing.

I’m fortunate to also work at UCLA Health and chatted with an inpatient pharmacist friend who tells me that Keppra can cause issues in patients who are prone to agitation and anxiety. I take meds for GAD, so I will err on the side of caution and request Brivicat which purportedly has fewer activating side effects. I’ll report back!

I’m preparing a list of preferences & requests for my care team at the hospital. Thinking about having a teeshirt made with them printed on it so they don’t get lost in the shuffle. (joking… kinda)

@moltroub Sound advice about speaking up if I don’t understand something! I’ve got an anxious mind as is so I’m good about chirping when I feel lost. I also also a huge proponent of mindful meditation and will be using every tool in my tool belt.

@FinWhaleFan Thank you for linking both of the resources - interestingly enough, I hadn’t seen the UCLA one. Love the suggestion about the discharge instructions before the surgery and will be sure to do that.

Thank you both for taking the time to respond!

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Ha! You are preaching to part of the choir.

Throughout my journey, I have become a huge fan of mindfulness as well. Such a powerful tool for managing stress and anxiety!

Will be sending good energy out to you.

Fin Whale Fan :whale:

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26 April 2026 newest members!
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Hello, goodsouldept! I’m a 49 year old non-smoker also with no blood pressure issues or family history of aneurysms. I had an 8mm unruptured supraclinoid saccular ICA aneurysm clipped in April 2025. I usually get nauseous from anesthesia, but had Zofran and that made a big difference. I still felt awful right after surgery, but that was just getting through the anesthesia fog. I didn’t have much pain unless I tried to lay flat – don’t do that for at least a week! I was actually able to get off Oxy after the first day, went home from the hospital after 2.5 days, and I was off Tylenol after 5 days. I was lucky in a lot of ways. But because my aneurysm was behind my left eye, I also had some cranial nerve injuries which meant that my eye and eyelid didn’t really move for many months after surgery, and I have had to deal with horrible double vision and a weird looking eye/eyelid. That was a surprise, and very difficult physically and emotionally to get through. Make sure you talk to your neurosurgeon. Understand all of the risks, and be prepared for potential complications. The other hard thing is that even though I’m a year past my surgery, I still get mentally exhausted if I do too much. And I’m not talking about going out late or anything exciting – I get tired from going out with a new friend to lunch. It’s surprising because my doctor had said that I’d be back to normal after 6-8 weeks, but that’s just not the case. Life isn’t 100% the same as it was pre-surgery. But it’s slowly getting back to “normal” and I’ve learned to adjust to the rest. I’m in a much better place physically and emotionally than I was 6 months ago. Recovery is more than just physical and will take way longer than you would expect. But you will get there. You have to just trust in the process.

I wish you all the best in your surgery and recovery!

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Oh my gosh what wise words and on your first post as well! Way to go Kris!

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I forgot a couple of things, @goodsouldept –

I also did a ton of exercise before surgery (45 mins high intensity cardio 5x/wk) and have a high stress job. With the job, I have told my manager that I need to do everything that I can to reduce my stress levels, and I actually force my type-A personality to do it. That was easy to do after surgery because my body just couldn’t keep going, and it had to become more intentional behavior once I could physically do it. Just because I can doesn’t mean that I do anymore.

With exercise, I had to slow it down once I was diagnosed until surgery – slow walks only. After surgery, I had to slowly ramp back up. It took many months to get back to 90% of where I was and I don’t even want to try to push my body back to 100%. This experience has taught me that I don’t need to do 100% in all of my life all the time. I actually feel healthier mentally and emotionally in accepting that.

Lastly, as far as pain, I forgot that I had to have my jaw muscle cut for my craniotomy. That was the pain that lasted the longest. It was only really bad for the first week, but after that I couldn’t even open my mouth an inch for months. Try eating a hamburger or a sandwich like that! I would just smash a hamburger into my face trying to wrestle it into my mouth. It ended up being OK many months later, and I am happy to say that I can eat again without getting food all over my face. Well, at least not because my jaw won’t open. :laughing:

Your experience will be different than anyone else’s on here, but now you know what you might be up against, and knowing is half the battle.

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Sorry to hear about your diagnosis, but I trust you will be fine. There are some fantastic doctors in so cal; they fixed me up.

I had a rupture with no clip. I can tell you the headaches weren’t pleasant, but going in unruptured is a huge advantage as I am sure you know by now.

I did chime in here because of the Keppra question. I’ll tell you this, it’s pretty potent stuff. The most important thing is you should not stop cold turkey. You are supposed to gradually decrease dosages over a period of time prescribed by your doctor or you can have some very odd things happen. Ask me how I know :slight_smile:

Also, ask your team for something for nausea and they should give you something to pretreat you. This is a very common and controllable issue.

I wish you the best of luck and I’m sure you will be back to your workout in no time. Just don’t push too hard too fast.

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Hello I wanted to send a quick note since I had clippings. Bilateral MCA bifurcation aneurysms, up to 6 mm on the right and 3 mm on the left were diagnosed with ER visit on July 1st 2024. When I got to Swedish Cherry Hill I had 2 on the left which they call sister aneurysms. The wait stressed me out. I imagine you’re going through it now yourself. I am sorry.
I threw up pretty bad on first - right side. And surgeon apologized saying it wasn’t mapped out for him.
Next day for the left side they used another anesthesia and I was fine. 3rd day they went back into to do a little repair work with skull for looks and I was fine then after that also. I felt no pain really after. And didn’t realize right away I had no taste or smell. Still don’t and believe in divine miracles since I am still here. Also no tears. But after all that I feel blessed. Doesn’t mean you don’t grieve how you were prior. You will go through a lot of feelings before and after. Glad you found this group. A great support. Prayers for you!

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@AprilFoolsDay2025 The post-anesthesia fog is the worst. Good note about lying flat - I had not heard this but it makes sense with the pressure, swelling and scalp tension. I’ll look into a wedge pillow as I have trouble sleeping upright.

I’m happy to hear your pain was well-managed (aside from the jaw pain) and while it’s disheartening to hear about your prolonged, reduced mental stamina, I’m glad you’re gradually returning to baseline. The emotional part of recovery is not something I’ve considered much, so thank you for your vulnerability. A couple friends have recommended that I establish a relationship with a therapist prior surgery in case I need that kind of support.

I’m also having a reckoning with my job and fitness routine. Like you, I ride myself hard and recognize that stress may be one of the factors that led to this diagnosis. I’ve never been great at self-moderation, so I’m having to re-evaluate everything I do. I think that will be one of the things I struggle with most in recovery - sitting my butt down and chilling out.

@Tony_P I definitely feel blessed being at UCLA. Brilliant suggestion about requesting pre-treatment for nausea - this is definitely something I’ll do. I also hadn’t realized that Keppra required weening!

@MLK The waiting & anticipation is certainly rough, especially because it gives me more time to research and freak myself out (lol). I appreciate the candor and I’m hoping your long term complications resolve with time. Thank you for the prayers.

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Good morning! I have a very similar story to yours;) and had a clipping done in November 2023 when I was 37 years old. My pain after surgery was completely manageable. The swelling was more bothersome than the pain! I think what caught me by surprise was how sensitive my brain was, and for quite awhile. I became overwhelmed so easily, and was extremely sensitive to noise (others I met were affected by different things- like light). I had concussion like symptoms and for me, that was the toughest part. My work was good about letting me return gradually. I am not sure what the first two things you mentioned on your post are. I was not offered those haha:)

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The hospital beds for NSICU are kept at 30 degrees due to ICP.

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Hello, I can’t answer all your questions but I had a clipping surgery back in 2017. Mine was to fix a failed coiling of a ruptured aneurysm that happened in 2013. So I already had some brain injury when it was clipped. Despite that, the clipping surgery was not really a big deal for me. I was only in the hospital 3 days and 1 of those was the surgery itself. Pain was not bad, mainly just a bad headache. I only took Dr. prescribed Rx Ibuprofen and a muscle relaxer. I also throw up after anesthesia and surgery and this was no exception. Opiod pain Rx makes nausea worse. It only lasted that one day of surgery. Mine was closed with staples. Removing those was not as painful as I feared. But use a baby shampoo until the staples/stiches are removed because regular shampoo will burn, a lot. When I went home from the hospital I was able to do everything I could do before the surgery (my rupture only caused a few neurological issues but my life was mostly normal after) but I did tire more easily for next month or so. I was able to do a 7 mile hike in the Colorado mountains 2 yrs after the clipping, at age 63. Depending on the location of your incision you won’t be able to sleep laying on that side so plan ahead regarding pillows. I was clear to drive “as soon as you think you can” per doctor. My surgery cut the tendon that works the jaw so if that is your’s be sure to exercise the jaw for weeks after. Like opening/closing/moving lower jaw side to side. Your scalp close to the incision will feel like it is weeping or dripping water starting a week or so after. This is the nerves healing. The clipping was way better/easier recovery than my rupture and coiling so being able to fix it before that happens is a huge benefit. And clipping is a permanent fix with fewer follow ups in the coming years. Now, after clipping, I get a CTA every 5 years vs coiling was a MRA every 6-12 months. Best wishes to you on a successful surgery and recovery!

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@JackieRo It’s so comforting hearing that the post-surgery pain is manageable. I’ve read about those pressure headaches and their symptoms. When you were going through that, how were you able to distinguish between what was a normal part of the healing process versus a possible complication that needed medical attention?

@viv22 I just purchased baby shampoo at your recommendation - thank you! Fortunately, I hoard pillows at home so I should have plenty of options. I’ve asked my coordinator about possibly bringing 1 or 2 for my stay since hospital pillows are notoriously uncomfortable. I will definitely do my jaw exercises! Thank you for sharing your experience and I so glad you were able to make it through relatively unscathed.

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@goodsouldept

Make sure that you have ready prepared meals in your fridge and freezer and your pantry well stocked before you have your surgery. Have your home in order, don’t be by yourself the first days after the surgery, someone has to stay with you. I’m sure you will do fine but waiting for the surgery is very difficult for the soul . Don’t rush your recovery, let your body rest and heal. I wish you all the best.

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