What is a Brain Aneurysm?
A brain aneurysm is a part of the blood vessel wall that is weakened and has bulged. This bulged area is full of blood. There are three types of aneurysms: saccular, fusiform, and mycotic. Each of these types can develop in any part of the brain. All aneurysms have the potential to burst or rupture, but not all aneurysms will. Aneurysms can be present at birth or can form later in life. Some of the risk factors for developing an aneurysm are smoking, uncontrolled high blood pressure, high cholesterol, and drug abuse, among others.
A brain aneurysm is diagnosed with high tech imaging. Often, an aneurysm is found on imaging that was performed for an unrelated reason. Imaging helps determine where the aneurysm is, how big, and what type (what it looks like).
Not all aneurysms require treatment. If the aneurysm is small and does not cause any symptoms, a doctor may choose to monitor the patient closely over time. Imaging is performed periodically to watch for any growth or progression that may require treatment. It is important for patients to manage any other conditions they may have that could contribute to the aneurysm such as diabetes, high blood pressure, high cholesterol, etc. It is also very important for patients to stop smoking and avoid illicit drug use.
How is a Brain Aneurysm Treated?
Aneurysms can be treated with surgery. This option includes either microvascular clipping or endovascular coiling. The decision for surgery depends on how high the potential is for the aneurysm to rupture, the size, location, the patient’s general health (to be able to safely undergo surgery/anesthesia), as well as the risk of not performing any treatment.
Microvascular clipping involves open brain surgery. The surgeon locates the aneurysm as well as the vessels that are supplying its blood. A metal clip is placed on the ‘neck’ of the aneurysm to block any blood flow. This is highly effective and decreases the chance an aneurysm forming again. Microvascular coiling does not involve open brain surgery. The surgeon inserts a small catheter into the patient’s artery – usually in the groin. The catheter is then guided up into the brain to the location of the aneurysm. Platinum wire is then inserted through the catheter and into the aneurysm. Coiling can be repeated if necessary.
There are also medications that can be used to manage some of the symptoms that a patient may experience. These include anti-seizure medications and calcium channel blockers. A shunt can also be placed if needed to direct extra cerebrospinal fluid from the brain to the abdominal cavity. This helps relieve pressure surrounding the brain.
If an aneurysm has burst, a patient may benefit from different types of rehab therapy. These services include speech therapy, physical therapy, and/or occupational therapy. Rehab can help a patient regain some or all of the lost function. If this is not possible, therapy can help a patient learn to live with any permanent disability that may be present.