A brain aneurysm occurs when a blood vessel develops a weak area in the wall that allows the vessel to balloon out and fill with blood. Approximately 1 in 50 people in the United States have a brain aneurysm, which are more prevalent in those ages 35-60. Aneurysms may not cause any symptoms, and you could live for years without knowing you have the condition. Many times, an aneurysm is found during an MRI or CT of the brain for another reason.
Brain aneurysms range in size from a few millimeters (very small) to more than 2 centimeters (about ¾ of an inch) . Not all aneurysms need treatment. Very small aneurysms are less likely to rupture, so you and your doctor may take a “wait and see” approach. There are several factors to think about when considering whether to have treatment, including:
- Your age
- Size, location and shape of the aneurysm
- Neurologic condition
- Any other medical problems
- Previous history of brain hemorrhage
Any aneurysm that ruptures is considered a medical emergency that needs immediate treatment. Symptoms of a ruptured aneurysm may include a sudden, severe headache (the worst in your life); problems with vision, eye pain, neck pain or a stiff neck. You also may see the following symptoms:
- Confusion, extreme tiredness, sleepiness or stupor
- Drooping eyelid
- Headaches with nausea or vomiting
- Problems moving any part of the body or muscle weakness
- Numbness or loss of sensation anywhere in your body
- Problems with speech
If you notice these symptoms in yourself or a loved one, call 911 and seek immediate emergency care.
The most common method of aneurysm repair is called clipping. This surgical procedure involves open brain surgery. During the procedure, the neurosurgeon places a metal clip at the bottom of the aneurysm to prevent it from rupturing.
Newer treatment methods have been developed that don’t involve brain surgery. During an endovascular repair, an interventional radiologist places a small catheter through the femoral artery (located in the groin area) and passes it through the body into the artery in the brain where the aneurysm is located. During the procedure, the doctor views the arteries on a monitor that displays high-speed images.
Once the catheter reaches the aneurysm, several methods can be used to seal the opening and prevent a rupture. A tiny coil can be placed into the aneurysm. The doctor uses a small wire with the coil attached. Once the coil is placed, a small electrical current is applied that detaches the coil and ensures it remains in place. A stent (a metal mesh tube) can be placed in the artery to cover the opening of the aneurysm. Stents can be used along with a coil.
Another method of sealing the aneurysm is to use a liquid called Onyx HD 500, which is a polymer that goes from liquid to solid state when it comes in contact with blood creating a seal. The interventional radiologist would inject the solution inside the aneurysm through the catheter. A small balloon is placed across the opening of the aneurysm and temporarily inflated so the solution doesn’t leave the aneurysm sac.
After the Procedure
Your recovery after treatment for an aneurysm depends on several factors. The open surgical clipping treatment generally means a longer hospital stay. You also will have an incision that will need to heal. Also, if the aneurysm ruptured, your recovery may take longer – up to three to four weeks depending on the effects of the bleeding in your brain.
The interventional radiology procedures usually mean a hospital stay of one to two days if there was no bleeding before the procedure. Recovery depends on your overall health and whether the aneurysm had ruptured. You may need to limit your activities after an endovascular procedure. Ask your doctor what activities you can do and when you can start doing things like using stairs, driving a car and exercising.
You will be given specific instructions when you leave the hospital. Make sure you understand the information including what medications you should take and when they should be taken, bathing instructions, activities you can engage in and when you should follow up with your doctor.
Please remember that any procedure has risks and benefits. Ask your doctor why a certain procedure is being recommended and what you can expect.
To learn more about brain aneurysms or to find a physician who treats this condition, please call us at (866) 358-4DOC.
Advanced Neuroscience Network (ANN) is an integrated delivery system of medical professionals and hospitals focused on offering a full continuum of neurological care throughout South Florida. Visit www.advancedneuronetwork.com to learn more.