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What is a Brain Aneurysm?

A brain aneurysm, also called a cerebral aneurysm, is a weakened section of an artery in the brain. When the artery wall weakens, it typically bulges out, similar to how a balloon inflates. The walls of an aneurysm are very thin, increasing the risk of rupturing and disrupting the movement of oxygenated blood to the brain.

When a brain aneurysm ruptures, blood floods out of the artery and into the space between the skull and brain. This is called a subarachnoid hemorrhage.

Hemorrhage in the brain can have severe and even life-threatening effects, leading to rapid changes in sodium levels, swelling in the brain tissue, a buildup of cerebrospinal fluid in the brain and seizures.

It’s important to take note of the symptoms and seek immediate medical attention when experiencing a severe headache or other symptoms far worse than anything previously experienced.

By far, the most serious consequence of an aneurysm is a rupture. However, brain aneurysms also fill with blood and can put pressure on the nerves and tissue in the brain. This can lead to a variety of dangerous and disruptive neurological symptoms.

Brain Aneurysm Symptoms

Brain aneurysm symptoms will vary depending on severity, location and whether it has ruptured. In many cases, patients with a brain aneurysm that has not ruptured may not experience any symptoms at all. But in cases where the aneurysm is enlarged or pressing on the nerves of the brain, a person might experience:

  • Blurry or double vision
  • Dilated pupils
  • Drooping eyelids
  • Pain behind one eye
  • Weakness or numbness

When a brain aneurysm ruptures, severe and intense symptoms often result that require immediate action and treatment. Symptoms of a ruptured aneurysm include:

  • Blurry or double vision
  • Confusion
  • Dilated pupils
  • Drooping eyelids
  • Nausea or vomiting
  • Pain above the eye
  • Seizure
  • Sensitivity to light
  • Stiff neck
  • The worst headache of your life
  • Unconsciousness
  • Weakness or numbness

How a Brain Aneurysm Is Diagnosed

Because brain aneurysms do not typically cause symptoms until they are severe or have ruptured, they are often not diagnosed until that point. If symptoms are exhibited and a doctor believes a brain aneurysm might be the cause, immediate and prompt diagnosis is necessary.

To confirm an aneurysm is present, a doctor will order imaging tests and other diagnostic testing, which may include CT, MRI, cerebral angiography and a cerebrospinal fluid analysis. CT angiography is also commonly used to capture sharp, detailed images of blood flow in the brain.

Diagnostic testing will identify whether and which type of aneurysm (either saccular, which means bulging out on one side, or fusiform, which bulges out on all sides) is present and whether the aneurysm has ruptured or is at risk of rupturing.

Treatment for Brain Aneurysms

Treatment options include microsurgical obliteration or “clipping” of the aneurysm via brain surgery where a clip is applied over the aneurysm. It’s a highly effective and well-researched procedure with excellent results for those that can tolerate brain surgery. Alternatively, brain aneurysms can also be sealed or “coiled” via a minimally invasive endovascular approach where the artery harboring the aneurysm can be accessed with consecutively small catheters via a small puncture at a groin artery. The aneurysm is then plugged with metal coils.

Endovascular treatment of aneurysms is newer technology and has been provided in the U.S. since the 80s as an excellent alternative. It is constantly being researched and advanced. In 2011, the FDA approved endovascular placement of flow diverters called Pipeline on select aneurysms. Briefly, instead of sealing the aneurysm with coils, a flow diverting stent-like material called “Pipeline” is placed within the artery harboring the aneurysm to divert blood from reaching the aneurysm. With time, there is progressively less blood flow to the aneurysm, which will eventually thrombose.

Our surgeons extensive training to provide both surgical (clipping, bypass) and endovascular (coiling or placement of Pipeline flow diverter) treatment options. We explain to our patients in great detail the indication to treat, and the comprehensive treatment alternatives to help patients decide the best course of action. Our neurosurgeons are trained and experienced in the microsurgical treatment of brain aneurysms and our neurointensivists who provide critical care for patients in our state of the art neurocritical care unit.

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Cerebral Vascular Conditions That We Treat