A cerebral aneurysm (also called a brain aneurysm or intracranial aneurysm) forms within the walls of an artery in the brain due to weakness in the blood vessels. Over time, the weak area of the artery becomes thinner and protrudes (like a balloon) due to blood flow and a tapping against the vessel wall. Most brain aneurysms form without any symptoms.
As time passes and the bulging artery becomes thinner, the aneurysm can rupture, causing bleeding in the brain. The symptoms of a ruptured aneurysm often include a sudden onset of severe headaches – most patients describe it as the worst pain they have felt head in your life.
A ruptured aneurysm can also be detected by imaging the brain – such as an MRI – when a patient is being evaluated for another condition. If an aneurysm is discovered, it is important to see a neurosurgeon in Delhi experienced in diagnosing, administering, and treating unruptured brain aneurysms.
Certain people are at increased risk for brain aneurysms. If you discover that you are at high risk, it is important to discuss screening tests with your brain surgeon in Delhi.
A ruptured brain aneurysm is a serious condition and requires immediate medical attention.
Types of Brain Aneurysms
There are two types of aneurysms that can occur in the brain:
- Saccular aneurysm: It is the most common type of aneurysm, and it is also called a “berry” aneurysm because of its shape. A saccular aneurysm is seen as a sac or berry that most commonly forms at an intersection (or “Y”) in the network of arteries located at the base of the brain (also called the Willis polygon).
- Fusiform aneurysm: A less common type of aneurysm that appears as a widening of the entire artery in the weak area.
Cerebral Aneurysm Facts
- Approximately 1 in 50 people have an unruptured brain aneurysm.
- Brain aneurysms are more common in women than in men (3: 2 ratio).
- Approximately 10-15 percent of patients diagnosed with a cerebral aneurysm will have more than one aneurysm.
- Brain aneurysms most commonly occur in adults ages 35-60, but can also occur in children. Most aneurysms develop after age 40 and have no symptoms.
- The diagnosis and treatment timely and accurate are important to ensure good outcomes for patients and survival.
- Approximately 15 percent of patients with a ruptured brain aneurysm (subarachnoid hemorrhage) die before reaching the hospital. Death occurs due to rapid and severe bleeding in the brain.
- Broken brain aneurysms cause death in about 40 percent of patients. Of those patients who survive, almost half will have some form of permanent disability.
WHO IS AT RISK OF SUFFERING A BRAIN ANEURYSM?
Aneurysms can be caused by several factors. Some people are at increased risk for a brain aneurysm. You may be at risk if you have any of the following medical factors or conditions:
- Important family history (more than one close family member with a brain aneurysm)
- Previous history of cerebral aneurysm
- Finnish ancestry
- Polycystic Kidney Disease
- Vascular Collagen Disease, such as Ehlers-Danlos Syndrome or Marfan Syndrome
- Female gender
- Fibromuscular dysplasia (FMD)
- Arteriovenous Malformations (AVM)
Risk factors for developing and bleeding from an aneurysm also include:
- High blood pressure
- Excessive alcohol consumption
WHAT ARE THE SYMPTOMS OF A BRAIN ANEURYSM?
Most ruptured aneurysms are small and do not cause obvious symptoms. Sometimes unruptured aneurysms are detected when they grow and press on nerves in the area, causing symptoms such as blurred or double vision. Symptoms of a ruptured aneurysm occur when the aneurysms rupture (causing bleeding in the brain), causing a severe headache or loss of consciousness.
Symptoms of Non-Broken Aneurysms
Most unruptured aneurysms do not cause any symptoms. Unruptured aneurysms can be found by chance when a person is receiving tests for other reasons, such as chronic headaches or carotid artery disease.
People with an unruptured aneurysm may have the following symptoms:
- Blurred or double vision
- Pain above or behind the eye
- Dilated pupil
- Fallen eyelid
- Problems with eye movement
- Weakness, numbness, or trouble speaking
- Chronic headache
Symptoms of a Broken Aneurysm
Most aneurysms will have no symptoms until they grow and rupture. When this happens, blood from the ruptured aneurysm enters the spinal fluid in the space around the brain. This type of bleeding is also called subarachnoid hemorrhage.
Symptoms of a ruptured aneurysm come on quickly and may include:
- Sudden and severe headache
- Neck stiffness
- Nausea and vomiting
- Sudden changes in mental status (drowsiness or loss of consciousness)
- Sudden pain above or behind the eye
- Sudden blurred or double vision
- Trouble walking or dizziness
- Sudden weakness and numbness
- Eye sensitivity to light
Bleeding in the brain can cause:
- Damage to brain cells
- Increased pressure on the brain
- Vasospasm (narrowing of blood vessels in the brain)
HOW IS A CEREBRAL ANEURYSM DIAGNOSED?
If you are experiencing aneurysm warning signs or symptoms, it is important to understand that this is an emergency medical situation and needs urgent intracranial aneurysm treatment in Delhi. The sudden onset of symptoms may indicate that the aneurysm has ruptured and is bleeding in the brain. An urgent neurological evaluation and tests are essential for survival.
An unruptured brain aneurysm can be found by taking pictures of the brain – such as an MRI or CT scan – or a medical evaluation for another reason, such as an evaluation for headaches or other neurological symptoms.
If you or someone you know is at high risk for a brain aneurysm, diagnostic tests can be done to detect an aneurysm.
If an aneurysm is discovered, it is important to see a neurosurgeon who has experience diagnosing and treating aneurysms.
Images of Brain Aneurysms
Aneurysms can be diagnosed by various imaging tests, including cerebral magnetic resonance angiography (MRA) and computed tomography (CT) angiography of the head (CTA).
A brain angiogram is a diagnostic procedure that evaluates the blood vessels in the brain for blockages or abnormalities, such as aneurysms. The test is carried out in a hospital by specialists called neuro interventionalists.
- The test involves inserting a catheter into a large blood vessel in the leg, which is directed into the brain.
- Then, a dye is injected, and x-ray photos of the blood vessels are taken as the blood moves through the arteries and veins.
- If an aneurysm is detected, this test determines the best treatment plan.
Computed Tomography (CT)
A CT scan uses x-rays to take a series of pictures of structures in the brain.
- This may be one of the first tests used to find out if you have an aneurysm.
- You may also receive a variant of this test called Computed Tomography Angiography (CTA) to show the blood vessels in the brain.
Computed Tomography Angiography (CTA)
A computed tomography angiography is a non-invasive radiographic test of the blood vessels in the brain using computed tomography technology.
- A series of thin X-ray cuts are taken after a dye is inserted through an IV into your arm.
- X-rays show a 3D image of the blood vessels and surrounding brain tissue.
- The test is easily tolerated by patients and takes only a few minutes.
- Patients with kidney problems may receive a different type of imaging test.
A lumbar puncture is a procedure to remove a sample of cerebrospinal fluid from your spinal cord using a needle to look for blood in the cerebrospinal fluid.
- If imaging tests show bleeding in the brain, there is likely to be blood in the fluid around the brain and spinal cord (cerebrospinal fluid).
- This test may be ordered if you have symptoms of a ruptured aneurysm, but the CT scan shows no evidence of bleeding.
Magnetic Resonance Angiography (MRA)
An MRA is a type of magnetic resonance imaging (MR) test that uses a magnetic field to evaluate blood flow through the network of blood vessels in the brain.
- A dye can be used during an MRA to show blood vessels more clearly.
- The MRA does not use X-rays.
- Claustrophobic patients may not tolerate this test.
- Patients who have metal implants or a pacemaker should not receive an MRA.
HOW IS A BRAIN ANEURYSM TREATED?
If you have been diagnosed with a brain aneurysm, the neurosurgeon in Delhi will evaluate all available options to develop the best treatment plan for you.
Individual factors that can affect brain aneurysm treatment in Delhi decisions include:
- Neurological condition
- Other initial medical conditions
- Aneurysm location
- Aneurysm size and shape
- Risk of rupture of the aneurysm
- Broken and unruptured aneurysms
If the aneurysm is not ruptured, options for management may include the following:
- Observation with follow-up images at regular periods of time to monitor changes in aneurysm size.
- Treatment of the aneurysm with surgical blocks or endovascular coiling.
Cerebral aneurysms can be treated surgically or with an endovascular approach – approximately 50 percent of aneurysms are treated with endovascular procedures, without the need for direct surgery.
OPTIONS FOR INTRACRANIAL ANEURYSM TREATMENT IN DELHI
Open Neurosurgery Craniotomy with Surgical Blocking Procedure
A craniotomy is a surgical operation in which an incision is made in the skull bone to locate and trim the blood vessel with the aneurysm.
- With the help of a microscope, the neurosurgeon locates the aneurysm and attaches a titanium clasp to block the aneurysm.
- Most aneurysm clips currently in use are compatible with MRIs.
- Often multiple snaps may be required.
- An angiography is performed after surgery to determine the effectiveness of the block.
- Normal hospitalization due to a craniotomy and aneurysm block is two to three days.
- Most aneurysms can be treated with a minimally invasive approach with a small incision in the eyebrow or hairline and with a silver dollar-sized opening in the skull.
Craniotomy with Cerebral Bypass Procedure
Brain bypass is performed for complex aneurysms that cannot be treated with traditional blocks.
- Through a craniotomy, a bypass is placed to change the path of the brain’s circulation around the aneurysm to prevent it from filling.
- An intraoperative measure of flow, plus an angiogram after surgery and a MRA NOVA are used to confirm patent bypass.
- Normal hospitalization after brain bypass is three to five days.
Endovascular Embolization Procedure
The embolization of an aneurysm is a non-surgical treatment that is carried out by a neurosurgeon in Delhi.
- Under general anesthesia, a small catheter is inserted through the femoral (thigh) artery into the groin and is directed into the brain.
- The catheter is carefully directed into the aneurysm, and small rolls of platinum are guided by means of a small catheter into the aneurysm to block it.
- Stents that direct flows are a newer technology in the non-surgical treatment of aneurysms.
- Hospitalization after aneurysm embolization is between two and three days.