Brain Aneurysms
What is a Brain Aneurysm?
Our bodies use a large network of blood vessels to bring blood to and from the brain. Arteries are vessels that bring oxygen-rich blood to tissues, and veins are vessels that bring oxygen-depleted “blue” blood away from tissues and back to the heart and lungs. When an artery has a weak spot in the wall, this may result in an out-pouching that bulges; this is called an aneurysm. A brain aneurysm refers to an aneurysm that occurs in the vessels that bring blood to the brain.
Brain aneurysms can vary in size and shape. Some are very small, only a few millimetres across, while others can grow larger — a “giant” aneurysm is one that is over 25 mm in diameter.
Aneurysms are relatively common, and research suggests that up to 6% of the population will develop a brain aneurysm at some point in their lives. If a person has one aneurysm, they may have a slightly higher chance of developing another aneurysm in the future.
What are the symptoms of a BRain Aneurysm?
An unruptured aneurysm may cause no symptoms at all. However, if it is of sufficient size to compress nearby brain structures or alter blood flow, certain symptoms may develop over time. These symptoms may include headache, vision changes, pupil dilation, or seizures.
If a brain aneurysm ruptures, it can be a serious medical emergency. When this happens, part of the brain may not get enough oxygen, which can cause stroke-like symptoms and, in severe cases, permanent disability, brain damage, or even death.
A ruptured aneurysm often leads to a sudden, severe headache, sometimes accompanied by nausea, vomiting, or seizures. While rupture is a serious concern, it’s important to know that not all aneurysms will rupture during a person’s lifetime.
The risk of rupture depends on several factors, including family history, lifestyle, other medical conditions, and characteristics of the aneurysm itself, such as its size, shape, and location. Understanding these factors helps your care team determine the best plan for monitoring or treatment.
How are brain aneurysms Diagnosed?
Unruptured brain aneurysms are often found by chance during imaging tests like a CT or MRI scan that were ordered for other reasons, such as headaches.
When an aneurysm ruptures, it usually causes sudden and severe symptoms. In these cases, patients go to the emergency department, where imaging is done to confirm bleeding in the brain.
Common Tests Used to Diagnose Aneurysms
CT Scan:
A quick, non-invasive test that uses X-rays to take detailed pictures of the brain. A CT angiogram (CTA) uses contrast dye to highlight blood vessels and can show if an aneurysm or bleeding is present.
MRI Scan:
An MRI uses magnetic fields instead of X-rays to produce highly detailed images. It helps doctors see the size, shape, and location of an aneurysm and how it relates to nearby brain tissue.
Cerebral Angiography:
A more detailed test often called the “gold standard” for diagnosing aneurysms. A thin tube (catheter) is inserted into an artery in the wrist or groin, and dye is used to create precise images of the brain’s blood vessels. This test helps doctors plan the best treatment approach.
What are the treatment options for Brain Aneurysms?
There are two main treatment options for brain aneurysms:
Endovascular treatment (a minimally invasive procedure done inside the blood vessels)
Open surgical treatment (a more traditional approach through the skull)
The right treatment depends on several factors — including your age, overall health, medical history, and the size and location of the aneurysm. Your care team will discuss the safest and most effective option for your individual situation, based on their expertise and experience.
Surgical clipping is the traditional treatment for brain aneurysms. It involves making a small opening in the skull so the surgeon can place a tiny clip at the base of the aneurysm. This stops blood from flowing into it and prevents the risk of rupture.
Endovascular treatment is a less invasive option. A thin tube (catheter) is guided through an artery—usually from the groin—up to the brain. Using X-ray guidance, the doctor can place tiny coils inside the aneurysm or use stents or flow diverters to redirect blood flow away from it.
Endovascular procedures often mean shorter recovery times and less discomfort. However, some aneurysms may need additional follow-up treatments to make sure they stay sealed.
Your care team will help you decide which option is best based on your aneurysm’s size, shape, and location, as well as your overall health and preferences.
