An aneurysm is a weak area in the wall of a blood vessel that causes the blood vessel to bulge or balloon out. When an aneurysm occurs in a blood vessel in the brain, it is called a cerebral or intracranial aneurysm.
Aneurysms can occur in other parts of the body as well. Common locations include the major artery from the heart (aortic aneurysm), behind the knee in the leg (popliteal artery aneurysm), the intestine (mesenteric artery aneurysm), and the artery in the spleen (splenic artery aneurysm).
Brain aneurysms can be present from birth (congenital) or can develop later in life from conditions such as hypertensive vascular disease or atherosclerosis.
A burst or ruptured brain aneurysm allows blood to go into the brain. When the blood supply to part of the brain is reduced or completely blocked, a stroke may occur.
Other problems may follow, including recurrent bleeding, water on the brain, and narrowing of the blood vessels. Brain aneurysms also can enlarge. Hemorrhaging (bleeding) occurs often without warning and is life threatening.
Although it is estimated that about 5 percent of people have or will develop brain aneurysms, few actually rupture. Ruptured brain aneurysms are more common in people in their 50s and 60s.
Brain Aneurysm Symptoms
Few warning signs precede a brain aneurysm until bleeding occurs.
Brain aneurysm symptoms after a rupture may include:
- Sudden and severe headache
- Vision or speech impairment
- Loss of consciousness
- Weakness on one side
- Numbness or tingling
- Nausea and vomiting
A ruptured brain aneurysm is a medical emergency. If you or someone you are with have the above symptoms, call 911.
Brain Aneurysm Diagnosis
In addition to physical and neurological examinations, neurosurgeons may request other tests such as:
Brain Aneurysm Treatment
Brain aneurysms are often emergencies by the time they are discovered. The aim of treatment once a hemorrhage has occurred is to stop the bleeding and damage to the brain and to reduce the risk of recurrence.
The weeks immediately following the hemorrhage are most important since that is the period when complications occur and re-rupture is most likely.
Treatment options for brain aneurysms include:
- Aneurysm coiling (assisted by balloon or stent) - In this minimally invasive procedure, your surgeon will insert a thin tube into your groin area and use imaging technology to guide the tube directly to your aneurysm. Your surgeon will push a tiny coil from inside the tube into the aneurysm (sometimes using a balloon or a stent to assist). The coil helps collect the blood and cause it to clot. This stops the aneurysm from leaking and prevents it from bursting again.
- Aneurysm gluing - This innovative, new procedure is similar to aneurysm coiling, but instead of inserting a coil, the surgeon injects a non-adhesive liquid embolic agent to help stem any leaking and prevent additional flow of blood. Currently, the liquid agent used is Onyx® HD-500. Wake Forest Baptist was the second hospital in both North and South Carolina to receive our certification for performing this new and advanced procedure.
- Aneurysm clipping - During this surgical procedure, your surgeon will first remove a part of the skull to gain access to the affected part of the brain. The surgeon will then insert a clamp at the bottom of the aneurysm. This will prevent the aneurysm from continuing to leak or from bursting again. Then, the surgeon will put the piece of removed skull back in place.
- Flow diversion - An aneurysm occlusion device (Pipeline®) is used in this procedure to reconstruct the parent artery by providing a flexible, supportive scaffolding across the neck of the aneurysm, redirecting blood flow away from the aneurysm (flow diversion). This is used in the treatment of wide-necked and large aneurysms amongst others.