What is a Brain Aneurysm?
A brain aneurysm is an outpouching from, or dilatation of, an artery in the space around the brain. Aneurysms typically form at locations where an artery branches, or makes a turn, and likely occur where there is a focal weakness in the wall of the vessel. This weakness in the vessel may be congenital, or may be the result of environmental factors – most commonly related to atherosclerosis, tobacco use and/or high blood pressure. Brain aneurysms are quite common, and may be present in up to 5% of the population. Aneurysms themselves typically do not cause any symptoms, but problems occur when aneurysms rupture and bleed, or when they grow to a large size.
Symptoms
Unruptured aneurysms rarely cause any symptoms. Occasionally, if an aneurysm is very large, it may cause symptoms due to compression of the brain or nerves around it. It is very unusual for unruptured aneurysms to cause headaches.
When an aneurysm ruptures, the most common symptom is a severe, sudden onset headache, often accompanied by vomiting, neck pain and sensitivity to light. This may rapidly progress to loss of consciousness, coma, and even death in the most severe cases. This is a medical emergency, and requires immediate treatment in the nearest emergency department.
Diagnosis
Most unruptured aneurysms are diagnosed incidentally, on a CT or MRI scan obtained for unrelated reasons. When an aneurysm is identified on a CT or MRI scan, in some cases, a diagnostic cerebral angiogram may be recommended for further evaluation.
Treatment Options
Many unruptured aneurysms do not require any treatment at all, however it is absolutely essential that any patient with a new diagnosis of cerebral aneurysm be evaluated by a cerebrovascular-specialized neurosurgeon or neuro-interventionalist to discuss management options.
Management may only include surveillance imaging to ensure that the aneurysm remains stable in size and shape. However, depending on the specific size and location of the aneurysm, and a variety of patient-related factors (age, medical comorbidities, patient preference, etc), some aneurysms do require treatment in order to minimize the risk of future aneurysm rupture. Aneurysm treatment options include both surgical clipping and endovascular therapies. The treatment options for a particular aneurysm also depend on a variety of aneurysm- and patient-related factors, including aneurysm size, shape and location, and patient age, medical comorbidities, and patient preference.
How Can We Help You?
The multi-disciplinary team at the Ayer Neuroscience Institute Neurovascular Program offers the full spectrum of care for patients with brain aneurysms, from diagnosis to treatment to lifelong follow up and support. Our experienced team of specialists includes fellowship-trained neurosurgeons, vascular neurologists, neuroradiologists, and subspecialized physician assistants, advanced practice registered nurses, and therapists.