Brain aneurysms are often undetected until they rupture or burst. A ruptured aneurysm is a serious medical issue, but it is possible to have an unruptured brain aneurysm that may never cause problems.
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What Is a Brain Aneurysm?
An aneurysm forms when the wall of an artery in the brain weakens and bulges or swells outward filling with blood. The bulge is the aneurysm. If that bulge tears or ruptures, the blood leaks into the fluid-filled space around the brain or into the brain tissue and can cause disability, brain damage, or death. However, not all aneurysms rupture. An experienced physician can provide an estimate as to the likelihood of rupture of specific aneurysms.
Unruptured Brain Aneurysm Symptoms and Diagnosis
Approximately 2 to 5 percent of the population have aneurysms and, if it doesn’t rupture, most people only find it by chance. Most unruptured brain aneurysms do not cause any symptoms. Some people discover them in a brain scan that they receive for a different reason, such as a head injury or headaches.
“Development of an aneurysm like this is a really slow process that takes years and often starts in one’s fifties,” Dr. Nathan Liang, MD, UPMC Heart and Vascular Institute, tells WPXI. “Most patients being treated for an aneurysm are usually in their sixties to eighties, but it can occur in younger patients as well.”
Doctors don’t fully understand what causes brain aneurysms to form, but a few factors increase the risk of developing one:
- High blood pressure
- Family history of aneurysms
Your doctor may recommend screening if you have two or more family members who have had a brain aneurysm.
Unruptured Brain Aneurysm Treatment
Once an unruptured aneurysm is identified, a decision needs to be made as to the management options. The recommendation is made depending on the estimated likelihood of the aneurysm to rupture, as well as the age and general health of the patient. The likelihood of rupture is dependent upon specific aneurysm characteristics which include size, shape, and location. For unruptured aneurysms, sometimes no treatment is recommended. Other times, your doctor may recommend a surgical procedure.
The aneurysm may be treated with microsurgical clipping or endovascular coiling. During clipping, a neurosurgeon makes a small window in the skull and, using a microscope, isolates the aneurysm. Then, the surgeon affixes a titanium clip to the base of the aneurysm. This clip excludes the aneurysm from the circulation and essentially eliminates the likelihood of it ever rupturing. Microsurgical clipping provides the most long-lasting treatment for aneurysms.
Endovascular coiling is another, less invasive treatment option. For this procedure, the surgeon inserts a catheter through the groin up to the blood vessels in the brain. The surgeon then places metal coils and/or stents in the aneurysm to stop blood from flowing into the aneurysm. Although less invasive, aneurysm growth and rupture are more likely to occur with coiling than with clipping.
Each patient and aneurysm are different; the decision about which procedure to have or whether to have surgery at all depends on the individual case. If you’ve learned you have an aneurysm, seek out an experienced care team at a hospital that knows how to perform both procedures.
“It’s really important to identify these aneurysms early and treat them, if necessary,” Dr. Liang says.
The UPMC Department of Neurosurgery has surgeons trained in both surgical procedures. Our physicians can provide a thorough consultation to help you understand the risks and benefits of any treatment path. To learn more or to schedule an appointment, call 412-647-3685.
Editor's Note: This article was originally published on , and was last reviewed on .
The UPMC Department of Neurosurgery is the largest academic neurosurgical provider in the United States. We treat conditions of the brain, skull base, spine, and nerves, including the most complex disorders. We perform more than 11,000 procedures each year, making our team one of the most experienced in the world. Whether your condition requires surgery or not, we strive to provide the most advanced, complete care possible. Our surgeons are developing new techniques and tools, including minimally invasive treatments. Find an expert near you.