A brain aneurysm is a weak spot in the wall of a blood vessel within the brain. The weakness allows the vessel to form an abnormal bulge that can rupture or burst like a water-filled balloon. A ruptured aneurysm that bleeds into the space around the brain is called a subarachnoid hemorrhage (SAH). There are also aneurysms that never rupture. Aneurysms can be different sizes and differ in shape. These indicate the type of treatment needed:
- Saccular (like a sack) with a narrow neck is also called a berry aneurysm because it looks like a berry growing from the side or branch of a blood vessel.
- Saccular with a wide neck of at least 4mm wide.
- Fusiform (spindle-shaped) and has no distinct neck.
What Are The Symptoms of a Brain Aneurysm
As aneurysms put pressure on the brain they can cause:
- A droopy eyelid
- Double vision or vision changes
- Pain above or behind the eye
- Dilated pupil
- Numbness or weakness on one side of the face, arm or leg.
A brain aneurysm that ruptures is extremely dangerous requiring immediate medical attention. Signs might be:
- The worst headache of your life
- Sudden loss of consciousness or alertness
- Numbness or weakness on one side of the face or body
- Mood or personality changes like confusion and irritability
- Nausea and vomiting
- Neck pain and stiffness
- Sensitivity to lights that hurts the eye
- Double vision or vision changes
- Eyelid drooping
- Seizures.
Treatment Options for Brain Aneurysm
The size and shape of the aneurysm and whether or not it has ruptured, plus the overall medical condition of the patient determines the treatment.
Medical Therapy
Unruptured intracranial aneurysms are often treated medically and might include blood pressure control and stopping smoking. Your doctor may also recommend routine monitoring which might include CT scan, angiography, MRA, all to monitor growth of the aneurysm over time.
Endovascular Coiling
During this endovascular procedure a catheter is fed into the femoral (main) artery in the groin and guided into the brain’s arteries. A fluoroscope is used to take images throughout the procedure so the surgeon can guide the coils without opening the skull. When the catheter reaches the aneurysm, very fine platinum coils fill the aneurysm, blocking blood flow. This prevents the aneurysm from rupturing.
Some types of aneurysms are difficult to treat with coils alone. If the opening of the aneurysm is large, the surgeon may insert a stent, a wire mesh tube to help support the blood vessel wall. This may also hold the coil in place. Most patients stay in the hospital overnight in ICU following the procedure while the incision is monitored.
Surgical Clipping
A craniotomy, a procedure to open the skull to expose the aneurysm is performed. A surgical clip made of titanium, pinches the neck of the rupture preventing it from bleeding into the brain. Most patients stay in the hospital for several days and generally recover within a few weeks.
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