Brain AneurysmA brain aneurysm, also called a cerebral or intracranial aneurysm, is an abnormal bulging outward of one of the arteries in the brain. It is estimated that up to one in 15 people in the United States will develop a brain aneurysm during their lifetime.
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 hemorrhage.
Subarachnoid hemorrhage from a ruptured brain aneurysm can lead to a hemorrhagic 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. Unruptured brain aneurysms are sometimes treated to prevent rupture.
Symptoms Of Brain AneurysmsOther ruptured cerebral aneurysm 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
Diagnosis Of Brain AneurysmsDiagnosis of a ruptured cerebral aneurysm is commonly made by finding signs of subarachnoid hemorrhage on a CT scan (Computerized Tomography, sometimes called a CAT scan). The CT scan is a computerized test that rapidly X-rays the body in cross-sections, or slices, as the body is moved through a large, circular machine. If the CT scan is negative but a ruptured aneurysm is still suspected, a lumbar puncture is performed to detect blood in the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord.
To determine the exact location, size and shape of an aneurysm (ruptured or unruptured), neuroradiologists will use either cerebral angiography or tomographic angiography.
Cerebral angiography, the traditional method, involves introducing a catheter (small plastic tube) into an artery (usually in the leg) and steering it through the blood vessels of the body to the artery involved by the aneurysm. A special dye, called a contract agent, is injected into the patient's artery and its distribution is shown on X-ray projections. This method may not detect some aneurysms due to overlapping structures or spasm.
Treatment Of Brain AneurysmsSurgery 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 neurovascular specialist to determine if they are candidates for either treatment.
Surgical TreatmentTo 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.
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