Aneurysms of Brain

What is a brain aneurysm?

Think of a weak spot in a balloon and how it feels stretched out and thin. A brain aneurysm is similar to that. It is a weak spot in the wall of a blood vessel inside the brain. That area of blood vessel gets worn out due to constant flow of blood and bulges out like a bubble. It can grow to a size of a berry. In rare cases these aneurysms can grow big and explode.

This will result in a stroke and needs immediate medical treatment since a ruptured aneurysm can cause

• Cerebral vasospasm: reduced blood flow into brain
• Hydrocephalus: too much fluid in the brain
• Coma an death
• Permanent brain damage

What are the symptoms?

A ruptured aneurysm can cause

• Nausea and vomiting
• Drowsiness
• Loss of balance and coordination
• Stiff neck
• Dilated pupils
• Increased sensitivity to light
• Blurred or double vision
• Drooping eyelids
• Confusion and altered sensorium
• Seizures

An unruptured aneurysm can cause

• Headache
• Dilated pupils
• Double vision
• Pain behind the eyes
• Drooping eyelids
• Difficulty in swallowing
• Weakness or numbness over one half of the face and body

What are the causes?

• Atherosclerosis: building up of fat inside the blood vessel
• High blood pressure
• Head injury
• Infection
• Cancers in head and neck
• Alcohol binging
• Family history of aneurysm
• Smoking and drug abuse

How is it diagnosed?

• CT scan and CT angiogram
• MRI and MR angiography
• Cerebral or brain angiogram
• Lumbar puncture if there is a suspicion of ruptured aneurysm

How do you treat it?

A ruptured aneurysm should be secured at the earliest to prevent a rebleed. It involves stopping the blood flow into aneurysm and at the same time taking care to avoid any injury to the main vessel.

This can be

• Surgical clipping: where a part of skull is removed and a metal clip is placed across the opening of the aneurysm to prevent blood flow into it. Then the skull bone is replaced.
• Endovascular coiling: here a tube is passed into the aneurysm from the groin of the patient and the aneurysm is sealed with metallic coils.
• Flow diversion: this is a treatment used in very big aneurysms. A stent is placed inside the vessel opposite the opening of the aneurysm and blood flow is diverted.

Surgical clipping

Endovascular coiling

What if the aneurysm is not ruptured?

• Avoid illegal drug abuse
• Stop smoking
• Lower blood pressure with diet and exercise
• Limit your caffeine
• Avoid lifting weights

Authored By Dr. Sai Sudarsan