Brain Aneurysm Diagnosis & Treatment

Diagnosis

A brain aneurysm, also called a cerebral or intracrainial aneurysm, is an abnormal bulging outward of one of the arteries in the brain. Often this wall is weakened by disease, injury or an abnormality present in the brain. Aneurysms are often caused or made worse by high blood pressure. It is estimated that up to one in 15 people in the United States will develop a brain aneurysm during their lifetime.

How is an Aneurysm Detected?

Several imaging techniques, such as X-ray angiography, MRI (magnetic resonance imaging) or computed tomography (CT), are used to detect aneurysms. In the image to the right, an angiogram shows a left-sided aneurysm. An Aneurysm may be small and not cause symptoms. A doctor will want to check it regularly to see if it is enlarging. Symptoms of an aneurysm depend on where it is located. Aneurysms in the brain can cause impaired vision and headaches. The larger an aneurysm becomes, the more likely it is to burst.

Unrupture Aneruysm

AN unruptured aneurysm can be diagnosed and treated to prevent rupturing with a procedure called “clipping” where a neurosurgeon surgically places special clips over the aneurysm to prevent it from breaking. Another way to treat it is by an interventional neuroradiologist surgically placing small coils in the aneurysm to fill it and keep it from rupturing.

Ruptured Aneurysm

When a blood vessel on the brain’s surface ruptures and bleeds into the space Between the brain and the skull (but not into the brain itself), it’s called a subarachnoid hemorrahage, which can lead to a hemorrhagic stroke, brain damage and death. When an artery in the brain bursts, flooding the surrounding tissue with blood, it’s called a cerebral hemorrhage.

Brain Aneurysm Treatments

The goals of treatment once an aneurysm has ruptured are: to stop the bleeding, stop potential permanent damage to the brain, and reduce the risk of recurrence. Surgery or minimally-invasive endovascular coiling techniques can be used in the treatment of brain aneurysms. However, not all aneurysms are treated at the time of diagnosis or are amenable to both forms of treatment. Patients should consult a neurovascular specialist to determine if they are candidates for either treatment.

“Clipping” Surgery

When possible, surgery is performed to prevent further re-bleeding episodes. The aneurysm is dissected using microdissection techniques, and a metal clip is placed across the aneurysm neck, so that no more blood flows into it.

Detachable Coil Embolization- Minimally Invasive

Aneurysms may be treated by placing detachable platinum coils (called the Guglielmi Detachable Coil, GDC) inside the aneurysm. The goal of the endovascular treatment is to pack the aneurysm tightly to close off blood flow into the aneurysm thereby preventing its rupture, or to reduce mass effect. These small, flexible wire platinum coils are delivered and inserted into the aneurysm using a catheter. The image here shows the subarachnoid hemorrhage (brain aneurysm) was treated by using detachable coil embolization.