Brain Aneurysm

Most important things to know about it

A brain aneurysm is a weakness in the wall of one or more of the brain’s blood vessels. This is mainly developed due to the thinning of artery walls. The leak or rupture in the aneurysm could prove fatal since it leaks the blood in the skull, on the surface or within the brain, termed as brain haemorrhage.

In the present era, when MRIs and CT scans are available easily, aneurysms are often detected during brain imaging ie MRI of the brain done for multiple conditions essentially headaches, brain injury or giddiness. The symptoms of brain aneurysm when it ruptures primarily are severe headache, the other symptoms could also be a stiff neck, seizure activity, altered sensorium, focal weakness.

The rupture of the aneurysm can cause disaster in the patients. Statistically, 20-25% patients do not reach the hospital to receive treatment. 50-60% patients who reach hospitals either succumb or are left with severe disability and need signifi cant help even in going through their daily lives. One third of the patients can go back to their profession. It is thus, important to identify the aneurysms which need to be treated before they rupture. It would not be right to treat all the aneurysms, as the treatment obviously would have inherent risk during the procedure averaging 2-3% (including risk to life or neurological dysfunction), which may not be conducive.

The risk factors for rupture is the size, shape and location of the aneurysm and history of ruptures of aneurysm in close family tree. Smoking, hypertension too increases the risk.

The identifi cation of the aneurysm could be on MRI, CT ANGIO or 4 vessel Angiography of the brain. The treatment of the aneurysm means obliteration of the aneurysm i.e cutting the aneurysm from the circulation. There are two options available. It can be fi lled with titanium coils to prevent bleeding. This is done by inserting a catheter through the groin artery and reaching the place. Other option is surgical clipping which is done by opening the skull and reaching the aneurysm and placing a clip at the neck of the aneurysm and cutting it off the circulation. Both the procedures obviously would have their advantages and risk factors. It goes without saying we need to tailor make a treatment for each aneurysm. This decision is based on the technical data of the aneurysm, like the size of the neck/ location /age of the patient. The opinion of the concerned doctor should be sought for further treatment plan.

Dr. Rajan Shah

Dr. Rajan Shah

Director & Head
Department of Neurosurgery
Nanavati Super Speciality
Hospital, Mumbai




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