What is a brain aneurysm?
A brain aneurysm, is also called a cerebral or intracranial aneurysm, is an abnormal bulging outward of one of the arteries in the brain.
Brain aneurysms are often discovered when they rupture, causing bleeding into the brain or the space closely surrounding the brain called the subarachnoid space, causing a subarachnoid haemorrhage. Subarachnoid haemorrhage from a ruptured brain aneurysm can lead to a haemorrhage stroke, brain damage and death.
The main goals of treatment once an aneurysm has ruptured are to stop the bleeding and potential permanent damage to the brain and to reduce the risk of recurrence. Un-ruptured brain aneurysms are sometimes treated to prevent rupture.
Incidence rates of Brain Aneurysms
Approximately 0.2 to 3 percent of people with a brain aneurysm may suffer from bleeding per year
10 to 15 percent of these patients will die before reaching the hospital and over 50 percent will die within the first thirty days after rupture. Of these who survive, about half suffer some permanent neurological deficit.
Brain aneurysms can occur in people of all ages, but are most commonly detected in those ages 35 to 60
Women are actually more likely to get a brain aneurysm than men, with a ratio of 3:2
Symptoms of Brain Aneurysms
Ruptured Cerebral Aneurysms Symptoms
Sometimes patients describing “the worst headache in my life” are actually experiencing one of the symptoms of brain aneurysms related to having a rupture. Other ruptured cerebral aneurysms symptoms include:
- Nausea and vomiting
- Stiff neck or neck pain
- Blurred vision or double vision
- Pain above and behind the eye
- Dilated pupils
- Sensitivity to light
- Loss of sensation
Unruptured Cerebral Aneurysm Symptoms
Before an aneurysm ruptures, patients often experience no symptoms of brain aneurysms. In about 40 percent of cases, people with unruptured aneurysms will experience some or all of the following cerebral aneurysm symptoms:
- Peripheral vision deficits
- Thinking or processing problems
- Speech complications
- Perceptual problems
- Sudden changes in behaviour
- Loss of balance and coordination
- Decreased concentration
- Short-term memory difficulty
- Fatigue
Because the symptoms of brain aneurysms can also be associated with other medical conditions, diagnostic neuroradiology is regularly used to identify both ruptured and unruptured brain aneurysms.
Diagnosis of Brain Aneurysms
Diagnosis of a ruptured cerebral aneurysm is commonly made by finding signs of subarachnoid haemorrhage on a CT scan (Computerized Tomography, sometimes called a CT scan).
To determine the exact location, size and shape of an aneurysm, neurosurgeons will use either cerebral angiography or tomographic angiography.
Treatment of Brain Aneurysms
Surgery or minimally-invasive endovascular coiling techniques can be used in the treatment of brain aneurysms. It is important to note, however, that not all aneurysms are treated at the time of diagnosis or are amenable to both forms of treatment. Patients need to consult a neurosurgeon to determine if they are candidates to either treatment.
Surgical Treatment
To get to the aneurysm, surgeons must first remove a section of the skull, a procedure called a craniotomy. The surgeon then spreads the brain tissue apart and places a tiny metal clip across the neck to stop blood flow into the aneurysm. After clipping the aneurysm, the bone is secured in its original place, and the wound is closed.
Coil Embolization
Endovascular therapy is a procedure that accesses the treatment area from within the blood vessel. In the case of aneurysms, this treatment is called coil embolization, or “coiling”.
Endovascular treatment of brain aneurysms involves insertion of a catheter 9small plastic tube) into the femoral artery in the patients leg and navigating it through the vascular system, into the head and into the aneurysms. Tiny platinum coils are threaded through the catheter and deployed into the aneurysm, blocking blood flow into the aneurysm and preventing rupture.
