Brain Aneurysm
Definition: A cerebral or brain aneurysm is a cerebrovascular disorder in which weakness in the wall of a cerebral artery or vein causes a localized dilation or ballooning of the blood vessel. Brain aneurysms may occur in any part of the brain but are mostly found at the base of the brain. The causes of aneurisms are unknown, however older age, congenital abnormalities, drug or alcohol abuse and hypertension may increase your risk of developing a brain aneurism. Symptoms that may be a sign of an unruptured brain aneurysm include:
- Headaches
- Dilated pupils
- Blurred or double vision
- Difficulty sleeping
- Drooping eyelid
- Pain behind or above the eye
- Weakness or numbness of the face
- Difficulty speaking
If you are experiencing confusion, lack of coordination, stiff neck, nausea, vomiting, drowsiness, sudden severe headache or seizures this may be an indication of an aneurysm rupture which requires emergency care as it can become life-threatening. Most brain aneurisms are diagnosed once symptoms appear and diagnostic tests have been done to identify the aneurism. The most popular way to determine the presence of a brain aneurism is to perform a cerebral angiogram in which a series of x-ray images are taken after a special dye is injected into the blood stream to better highlight the arteries and blood vessels. The details and state of your arteries can then be better diagnosed. Because this test is rather more invasive, Dr Lamprecht may choose to first run an MRI scan to take images of the brain from 3-dimensional angles.
Treatment: Surgical Clipping entails performing a craniotomy, exposing the aneurysm, and closing the base of the aneurysm with a clip chosen specifically for the site. Endovascular coiling entails passing a catheter into the femoral artery in the groin, through the aorta, into the brain arteries, and finally into the aneurysm itself. Once the catheter is in the aneurysm, platinum coils are pushed into the aneurysm and released. These coils initiate a clotting or thrombotic reaction within the aneurysm that, if successful, will eliminate the aneurysm. It is important to distinguish between an ischemic stroke or a hemorrhagic stroke. Ischemic stroke is caused by a clot or a narrowing of a blood vessel but hemorrhagic can be caused by an aneurism that has burst.
Cranial Condition
Brain Aneurysm
Cranial · Vascular
A brain (cerebral) aneurysm is a weak, bulging area in the wall of an artery in the brain. Most aneurysms are small and never rupture, and many are found incidentally on scans done for unrelated reasons. A ruptured aneurysm, however, is a medical emergency causing bleeding around the brain (subarachnoid haemorrhage).
Common Symptoms
- Often no symptoms at all until found incidentally on a scan
- A sudden, severe “thunderclap” headache (if ruptured)
- Neck stiffness
- Sudden vision changes, drooping eyelid or double vision
- Sudden weakness, numbness, slurred speech or confusion
- Loss of consciousness
Causes
Aneurysms can develop from a combination of factors including high blood pressure, smoking, family history, and natural weaknesses in blood vessel walls. Certain genetic and connective tissue conditions also increase risk.
Diagnosis
Unruptured aneurysms are usually found on CT or MRI angiography done for other reasons. If a rupture is suspected, an urgent CT scan and CT or catheter angiogram are used to confirm the diagnosis and map the aneurysm before treatment.
This is a medical emergency if: you or someone you’re with experiences a sudden, severe headache unlike any before, especially with neck stiffness, vomiting, loss of consciousness or new neurological symptoms — call an ambulance or go to the emergency room immediately.
Treatment Approach
Unruptured aneurysms are assessed for size, shape and location to weigh the risk of future rupture against the risks of treatment; some small aneurysms are simply monitored. When treatment is indicated, options include microsurgical clipping (craniotomy) or endovascular coiling, performed in collaboration with interventional colleagues where appropriate. Ruptured aneurysms require urgent treatment to secure the aneurysm and manage complications of the bleed.
Frequently Asked Questions
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