What is a Cerebral Aneurysm?

A cerebral aneurysm is an aneurysm that occurs in one of the arteries that supplies blood to the brain. It is commonplace to have an aneurysm because blood pressure is higher in the arteries.

When a brain aneurysm ruptures, a subarachnoid hemorrhage occurs. Depending on the severity, a stroke, brain damage, or even death can result.

Aneurysms are very dangerous if they rupture or burst. However, even unruptured aneurysms may cause headaches, dizziness, loss of concentration, neck pain, fatigue, and vision problems.

How are Cerebral Aneurysms Detected?

Cerebral aneurysms can be detected in three ways: via an angiogram, an MRA (magnetic resonance angiogram), or a CTA (computed tomography angiography).

The staff at Neurosurgery and Endovascular Associates, as well as the practice’s Spine and Brain Imaging Center, are experts in the field of advanced detection of cerebral aneurysms.

Angiogram

An angiogram is a very accurate imaging technique used to see how blood flows in the arteries and veins in real time.

During an angiogram, a catheter is placed through an artery in the groin and advanced to a blood vessel in the brain. Dye is injected into the artery, which can be seen by a fluoroscope, a special x-ray machine that captures video.

When angiograms are performed the images are displayed as a continuous video, so it is easy to see where the blood actually goes. This is an invasive test, but it is the best way to detect small aneurysms.

MRA

An MRA is a 3-dimensional, non-invasive imaging technique that allows doctors to see the structure of the blood vessels in the brain. An MRA is very similar to an MRI.

CTA

A CTA is also a 3-dimensional, non-invasive imaging technique that allows Dr. Ahuja to see the structure of the blood vessels in the brain by combining CT scanning and imaging after dye is injected through an IV.

How are Cerebral Aneurysms Treated?

Depending on the severity of the aneurysm and associated risk factors, an aneurysm will either be treated through observation and management, endovascular treatment, or surgical treatment.

Observation

If your aneurysm is at a low risk of rupturing or if an intervention wouldn’t be appropriate, Dr. Ahuja will recommend a conservative course of treatment.

This treatment most likely involves blood pressure monitoring, because high blood pressure can increase the risk of an aneurysm rupturing.

Dr. Ahuja would also likely want you to get imaging performed every one to two years to monitor the size of the aneurysm.

If you suddenly begin to experience worsening symptoms such as headaches, dizziness, or vision problems, seek help immediately and call 9-1-1.

Endovascular Treatment

During the endovascular treatment of an aneurysm, Dr. Ahuja will advance a catheter from the femoral artery in your groin to the desired blood vessel in your brain.

Much like an angiogram, the procedure will be guided through fluoroscopy, a special type of x-ray that allows Dr. Ahuja to see the catheter and aneurysm in real time on a video screen.

One way to treat an aneurysm is with endovascular coiling. In this procedure, flexible platinum coiling is inserted into the aneurysm until it curls into a tight ball. If needed, a Nitinol stent is put in place to stabilize both the coiling and the blood vessel. Once in place, the coil and stent prevent the aneurysm from rupturing.

Surgical Treatment

The surgery Dr. Ahuja would perform to treat an aneurysm is a called a craniotomy for an aneurysm clipping. In a craniotomy, a small portion of the skull called a bone flap is removed (and replaced later in surgery) so Dr. Ahuja can gain access to your brain. Next, he opens the thin layer surrounds the brain called the dura.

When the dura is opened, Dr. Ahuja locates the aneurysm in your brain based on the imaging results. Once the aneurysm is located, a small metal clip is very carefully placed at its neck, cutting off its blood supply and obliterating the aneurysm.

Sometimes multiple clips need to be used depending on the shape, size and blood supply of the aneurysm. After the aneurysm is clipped, the dura is sutured closed and the bone flap is replaced and secured with small metal plates and screws.