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Phone: (303) 597-1724
Fax: (303) 788-7666
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Swedish Medical Center and CNI's Stroke Center form the only Accredited Comprehensive Stroke Center in the region

Brain Aneurysm

What is a brain aneurysm?

A brain aneurysm, also called a cerebral or intracranial 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 at birth. 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.

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 hemorrhage, 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.

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 aneurysms

Ruptured Cerebral Aneurysm Symptoms
Sometimes patients describing "the worst headache in my life" are actually experiencing one of the symptoms of brain aneurysms related to having a rupture. Other 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

Unruptured Cerebral Aneurysm Symptoms
Before an aneurysm ruptures, patients often experience no symptoms of brain aneurysms. In about 40 percent of cases, people with unruptured aneurysms will experience some or all of the following cerebral aneurysm symptoms:

  • Peripheral vision deficits
  • Thinking or processing problems
  • Speech complications
  • Perceptual problems
  • Sudden changes in behavior
  • Loss of balance and coordination
  • Decreased concentration
  • Short-term memory difficulty
  • Fatigue

Because the symptoms of brain aneurysms can also be associated with other medical conditions, diagnostic neuroradiology is regularly used to identify both ruptured and unruptured brain aneurysms.

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's enlarging. Symptoms of an aneurysm depend on where it's located. Aneurysms in the brain can cause impaired vision and headaches. The larger an aneurysm becomes, the more likely it is to burst.

How is a brain aneurysm treated?

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 need to consult a neurovascular specialist to determine if they are candidates for either treatment.

When possible, surgery is performed to prevent further re-bleeding episodes. The aneurysm is dissected out 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.

CNI's treatment team for aneurysm includes:

CNI Aneurysm Treatment Team

CNI Interventional Neuroradiology Service
CNI Neurovascular Surgery Service
CNI Stoke Center Team

Related Websites:

www.brainaneurysm.com
American Heart Association
Detachable Coil Embolization

How Common Are
Brain Aneurysms?

According to the American Society of Interventional and Therapeutic Neuroradiology (ASITN), the facts about brain aneurysm include:
  • Approximately 0.2 to 3 percent of people with a brain aneurysm may suffer from bleeding per year.
  • The annual incidence of aneurysmal subarachnoid hemorrhage in the U.S. exceeds 30,000 people. Ten to 15 percent of these patients will die before reaching the hospital and over 50 percent will die within the first thirty days after rupture. Of those who survive, about half suffer some permanent neurological deficit.
  • Brain aneurysms can occur in people of all ages, but are most commonly detected in those ages 35 to 60 .
  • Women are actually more likely to get a brain aneurysm than men, with a ratio of 3:2.

 
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Colorado Neurological Institute Stroke Center
701 East Hampden Ave., Suite 415, Englewood, CO 80113
Phone: (303) 597-1724, Fax: (303) 788-7666
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The medical information presented on this website is meant for general educational purposes only.
Persons should consult their physician regarding specific medical concerns or treatment. Copyright 2005, Colorado Neurological Institute.
 


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