A brain aneurysm, or cerebral aneurysm, is a bulge in the wall of an artery in the brain caused by a weak spot in a blood vessel wall. It may be present at birth or develop after an injury. They are more common in adults than children and may form over time.
While serious, with monitoring and treatment, you can survive a brain aneurysm. A ruptured brain aneurysm requires emergency treatment. If you experience any of the symptoms listed below, seek emergency care.
Brain Aneurysm Risk Factors
Factors that can put you at risk for a brain aneurysm include:
- Cigarette smoking
- High blood pressure
- High alcohol consumption
- Family history
- Certain genetic conditions
Brain Aneurysm Symptoms and Related Risks
Many people have no idea they have a brain aneurysm because they have no symptoms. Brain aneurysms are commonly discovered and diagnosed on brain imaging during work-up for an unrelated condition.
Brain aneurysms put you at risk for a subarachnoid hemorrhage — bleeding between the brain and its surrounding membrane. A head injury can trigger the rupture of a brain aneurysm, or pressure can cause the aneurysm to develop leaking that increases over time.
The risk of subarachnoid hemorrhage for a particular brain aneurysm depends on its size, shape and location. Ruptured brain aneurysm symptoms include:
- Sudden severe headache
- Vision changes
- Neck pain
- Loss of consciousness
Seek emergency care if you experience these symptoms — particularly if you have a known brain aneurysm that a doctor is monitoring.
Waukesha teacher had aneurysm burst after giving birth to daughter
Froedtert & MCW neurosurgeon John Nerva, MD, talked with Fox 6 about the "coiling" procedure used to treat Kirsten Wiesneski's aneurysm. Kirsten's aneurysm ruptured just hours after she gave birth to her daughter.
Brain Aneurysm Treatments
The goal of brain aneurysm treatment is to eliminate the risk of future hemorrhage while minimizing the risks of treatment. We look at your overall health and health history, as well as your brain aneurysm characteristics, in the decision to recommend treatment. We also use this analysis to determine the best type of treatment for you. Froedtert & MCW doctors specialize in treating these complex conditions and offer the latest treatment advances.
Unruptured brain aneurysms can be closely observed with a series of imaging studies (brain scans) that look for changes in the aneurysm.
Based on monitoring or a sudden development of symptoms, your doctor may recommend surgical intervention. There are several minimally invasive surgical treatments — including microsurgical clipping and endovascular embolization. Microsurgical techniques work on the outside of the blood vessels, while endovascular techniques work from the inside of the blood vessels using thin, hollow plastic tubes called catheters.
Some techniques close off the aneurysm, while others use flow-diversion devices to route blood flow away from the aneurysm and down the normal course of the blood vessel.
Coil Embolization (Coiling)
Coil embolization, or “coiling,” is the most common endovascular treatment. During coiling, your surgeon uses X-rays and contrast dye as a roadmap to navigate and place catheters at the site of the brain aneurysm. This minimally invasive surgery only requires a small incision in the wrist or groin depending on where the aneurysm is and the artery we need to access. After making the incision, your doctor guides tightly packed platinum coils through the catheter and places them close to the aneurysm to encourage clot formation that will close the aneurysm and prevent bleeding into the brain.
In addition to coiling, there are several other endovascular techniques used to treat brain aneurysms, including stent-assisted coiling, flow diversion and other intra-aneurysmal devices that are constantly evolving. The endovascular approach may offer shorter treatment time, less pain and faster recovery than traditional open surgical procedures.
Brain Aneurysm Clipping
Placing a small metal clip at the base of the aneurysm is another method of treatment. The clip stops the blood flow to the aneurysm, keeping it from bursting or leaking blood into the brain. This treatment involves removing a portion of the skull (craniotomy) and locating the blood supply to the aneurysm.
Eyebrow Approach to Clipping
At Froedtert & MCW health network, we are able to perform brain aneurysm clipping by making a small incision in your eyebrow followed by a small opening in your skull. In addition to a smaller incision and smaller skull opening than traditional approaches, it is a shorter procedure with less recovery time. After healing, the tiny scar is covered by your eyebrow hair. There is also less pain and scalp numbness than there is with a standard approach.
The eyebrow approach to clip a brain aneurysm carries the same risks as other approaches. It takes about three hours to complete the procedure. You can expect to spend one or two days in the hospital followed by 10 days at home with minimal lifting. After that, you can return to your normal activities.
The Froedtert & MCW aneurysm treatment team is one of only a few centers that offer the eyebrow approach.
Minimizing the Risks of Brain Aneurysm Treatment
It is important to choose the correct procedure for each patient. Any treatment carries risk, but patient outcomes are better at centers like the Froedtert & MCW Neuroscience Center that treat a high volume of brain aneurysms. Our patient care is performed by a highly experienced and skilled multidisciplinary team. Our expertise in both microsurgical and endovascular techniques allows us to offer the most appropriate treatment for our patients.