A brain or cerebral aneurysm is a cerebrovascular disorder in which the wall of an artery in the brain becomes weak and balloons outward. The ballooned part of the artery is the aneurysm.
An aneurysm has thin walls and can leak or rupture easily. Aneurysms can form in many sizes and can rupture at any time. The rupturing of an aneurysm is called a subarachnoid hemorrhage and causes blood to leak into the fluid-filled space around the brain. This bleeding is very dangerous and can cause brain damage, disability, or death.
Treatment depends on the location of the aneurysm, and may include clip ligation using neuroendovascular surgery, aneurysm coiling, or in select cases, the Endoscopic Endonasal Approach (EEA), which are all available at UPMC. EEA is an innovative, minimally invasive technique that uses the nose and nasal cavities as natural corridors to access the aneurysm.
At UPMC, we take a 360° Approach to treatment when evaluating each patient—looking at their conditions from every direction—to find the path that is least disruptive to the patient's brain, critical nerves, and ability to return to normal functioning. Our neurosurgical team may recommend a combination of surgical and non-surgical approaches to maximize the benefits of surgery while minimizing risks.
A doctor will perform several tests to diagnose a cerebral aneurysm and will ask about your symptoms.
Symptoms may include:
- severe sudden headache
- nausea and vomiting
- loss of consciousness
- stiff neck
- fever
- sensitivity to light
A CT scan of the head is performed to look for blood in the brain. If the CT scan does not show a problem, a lumbar puncture (spinal tap) and angiogram will be performed. The lumbar puncture determines whether there is blood in the cerebrospinal fluid. If blood is found in the cerebrospinal fluid, this means a subarachnoid hemorrhage has occurred.
An angiogram shows the exact location of the aneurysm. Dye is injected through a catheter placed in a blood vessel in the neck. This dye is visible on x-rays and shows whether there is any bleeding. After the diagnostic tests are completed, the doctor will recommend the best treatment plan for the patient.
A ruptured brain aneurysm is a medical emergency and the clinical team will move quickly.
Treatment options may include:
Clip ligation
During this surgery, a metal clip is placed at the base of the aneurysm to control the bleeding and to decrease the risk of more bleeding. This procedure often requires a small craniotomy, which is the creation of a window in the skull. This allows the surgeon to go around the brain with the help of endoscopes and microscopes to detect the aneurysm and clip it. Endoscopic Endonasal Approach (EEA) can sometimes be utilized for aneurysm clipping.
Aneurysm Coiling is used to block the blood vessel supplying blood to the area of the brain with the aneurysm. Metal coils are placed in the aneurysm through a catheter that is inserted in the groin area. This surgery will prevent further bleeding.
