When you hear the term “aneurysm,” the first thought is to seek immediate attention. All brain aneurysms are not the same, but treatment is critical when they occur.
A brain aneurysm (also known as a cerebral aneurysm) is a bulging, weakened area in the blood vessel wall. When that weakness leaks or ruptures, it can cause a brain bleed or hemorrhagic stroke. Brain aneurysms can happen to anyone at any age but are most common in adults between 30 and 60 years of age.
A person with a ruptured aneurysm has the best chance of recovery if they seek medical intervention. Without it, they can suffer severe disability or even die.
Endovascular surgery can help treat or prevent a hemorrhagic stroke.
Brain Aneurysm Symptoms
Brain aneurysms can be different in size and location and can cause different symptoms.
Most brain aneurysms occur without any clear predisposition. Sometimes, a patient may have small bleeds from an aneurysm before the brain hemorrhage occurs. These events are called “sentinel bleeds” and present as a sudden headache.
Asymptomatic brain aneurysms are those which go undetected until they grow or burst. These unruptured cerebral aneurysms often are found during unrelated tests.
If an aneurysm is growing and pressing on a nerve, you may experience:
- Facial pain or headaches.
- Vision changes.
- A dilated pupil in your eye.
When an aneurysm bursts, common symptoms include:
- Sudden and severe headache.
- Sensitivity to light.
- Vision impairment.
- Nausea and vomiting.
- Loss of consciousness.
- Stiff neck or neck pain.
- Cardiac arrhythmias.
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How Do I Know I Have a Brain Aneurysm?
Diagnostic tests and procedures can help determine if your symptoms are the result of a brain aneurysm. These tests may include:
- Magnetic resonance imaging (MRI) — Doctors use a scan of the brain to obtain images when they suspect an unruptured aneurysm.
- Computed tomography (CT) scan — Doctors perform a CT scan of the brain if a rupture is suspected and bleeding is apparent.
- Diagnostic angiogram — Doctors use angiogram to gain insight into the arterial system to look for blockages. First, they thread a thin tube called a catheter to the arteries of your brain. Then they inject iodine dye into the catheter and take a series of x-rays, which can reveal a blockage. This procedure is the gold standard for detecting a brain aneurysm.
- 3D angiogram — This type of CT angiogram can show a narrowed or blocked blood vessel, as well as an aneurysm.
Endovascular Surgery for Aneurysms
Endovascular means “inside the blood vessel.” Endovascular surgery is a type of minimally invasive surgery designed to access blood vessels using catheters. These catheters allow doctors to access the blood vessels from the arm or groin.
Endovascular neurosurgery is an advanced, developing field. Providers can explore and treat conditions by gaining access to the damaged blood vessels inside the brain in a less-invasive way. New catheters used along with advanced imaging provide access for surgeons to navigate a smaller area in the body and restore blood flow or prevent a clot from traveling.
Endovascular surgery is used to address intracranial bleeds, perform aneurysm stenting and coiling, and treat arteriovenous malformations (AVMs) in the brain or spine. It is an alternative to more invasive aneurysm procedures, such as craniotomy — which requires a surgical cut in the skull to access the brain.
A new technique in treating brain aneurysms uses a special catheter to access the radial artery — an artery of the wrist. This technique helps divert the blood flow away from the aneurysm with a stent, allowing the vessel wall to heal.
Minimally invasive robotic-assisted surgery is another endovascular surgical option. It gives surgeons the ability to control catheters and other tools with even more precision.
Endovascular surgery benefits patients with faster recovery and fewer complications compared to open surgery. Many patients can leave the hospital in one or two days and resume normal activities in two to four weeks.
Am I at Risk for a Brain Aneurysm?
There are few known risk factors for brain aneurysms, including:
- Being female.
- A family history of stroke or brain aneurysms.
- Previously diagnosed aneurysms.
- A diagnosis of collagen vascular disease.
These factors cannot be changed. You should talk to your doctor about preventive care to decrease your risk.
Other risk factors, including hypertension (high blood pressure) and smoking, are within your control. Doctors recommend people make healthy lifestyle choices such as quitting any tobacco use, getting daily exercise, and eating a healthy diet. This can limit potential diseases associated with high blood pressure.
The UPMC Department of Neurosurgery treats common and complex conditions of the brain, spine, nerves, and blood vessels. To find care close to you, visit our website.
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.