Neurosurgeon Questions Blood Clots

My mother has a blot clot in the right side of her brain. Is surgery the only option to remove it?

My mother is 65 years old and has been diagnosed with a blood clot on the right side of her brain. The doctors have recommended a surgery, however she is very scared. Mainly because of her age. Is surgery her only option?

4 Answers

It depends on her symptoms and the size and location of the blood clot. Clots can be outside the brain, such subdural and epidural. They can be inside the brain substance, such intracerebral or intraventricular. Subarachnoid hemorrhages occur in a space intimately close to the surface of the brain. Surgery is decided case by case.
Her age is not a prohibitive factor. Surgery in some form may be the best solution but watchful waiting can also be a solution. It depends on why she had the clot, where it is in the brain and what her over all neurological exam is. Her baseline state of health and function also would be important to consider. Talk with her physicians and they can answer any particular concerns you may have.
If she has time to think about surgery as an option, she may improve over time without surgery. Indications for hemorrhage removal on the right will mostly be left sided weakness. Bleeding will dissolve similar to a bruise. The difference is how the brain tolerates the pressure. If the bleeding is inside the brain, the cause needs to be evaluated. Most bleeding inside the brain rather than between the brain and skull has less surgical indications. Consultation with your surgeons should continue.
Some clots can be life threatening and need to be removed. They should be removed if it is causing a progression of symptoms from consciousness to loss of consciousness to coma, due to brain herniation.

Some clots are due to Abnormal blood vessels bleeding in the brain, therefore surgery would be recommended in some patients to remove the abnormal vessels. It is important to rule out this cause. In this case other treatment options may include endovascular procedures rather than brain surgery.

Many patients can recover without surgery depending on the clots location and if the blood clot is stable in size and not expanding. The brain will eventually absorb the blood clot.

Regarding your mothers age of 65 years. She still has a long life to live. If surgery is indicated or recommended by her neurosurgeon, then the chances of a favorable outcome are in her favor.