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A brain aneurysm, or cerebral aneurysm, is a bulging weak spot in a blood vessel in the brain. Brain aneurysms usually form in people after age 40 – people aren't normally born with them. They can develop where arteries branch and result from the constant pressure of blood flow. Aneurysms can grow slowly, filling with blood and weakening the artery like a balloon weakens as it expands with air.
Brain aneurysms are dangerous because they can burst, causing bleeding within or on the outer layer of the brain. When an aneurysm bursts it becomes a hemorrhagic stroke. Brain damage from a burst aneurysm can cause disability or death.
A the University of Maryland Medical Center, our neurosurgeons surgically repair aneurysms frequently. We'll create a plan to for you that is safe and will give you the peace of mind knowing that your aneurysm is no longer an issue. Please call 410-328-4323 to make an appointment.
Brain Aneurysm Symptoms
Small, stable aneurysms usually don't have any symptoms. Unruptured brain aneurysms won't normally have symptoms until they become very large. A large, unruptured aneurysm can press on nerves and cause:
- Dilated pupil in one eye
- Double vision
- Pain above and behind the eye
- Paralysis on one side of the face
Burst aneurysms, essentially a hemorrhagic stroke, have sudden symptoms including:
- Severe, sudden headache (the worst headache of one's life)
- Double vision
- Paralysis or weakness of the face, arm or leg
- Confusion or trouble speaking
- Nausea, vomiting or coma
- Cardiac arrest
Call 911 immediately if you or anyone around you has one or more of these symptoms.
Diagnosing Brain Aneurysm
Unruptured brain aneurysms are often found during imaging tests for other conditions. If you have any symptoms of a burst aneurysm or hemorrhagic stroke, you may have diagnostic imaging procedures including:
- CT (computed tomography), a fast and painless test that can determine if blood has leaked into the brain.
- CTA (CT angiography), a CT scan that uses a dye injected into the bloodstream to show the size, location and shape of an unruptured or a ruptured aneurysm.
- MRI (magnetic resonance imaging), a scan that uses computer-generated radio waves and a magnetic field to create two- and three-dimensional detailed images of the brain.
- MRA (magnetic resonance angiography), a type of MRI that uses a dye injected into the bloodstream and can show an aneurysm's size, location and shape.
- Cerebral angiography uses a catheter, X-ray imaging guidance and dye contrast to diagnose brain aneurysms and other arterial conditions. The catheter allows diagnosis and treatment in one procedure.
- CSF (cerebrospinal fluid) analysis, a test that measures chemicals in cerebrospinal fluid, that surrounds the brain, to detect bleeding in the brain.
Treating Brain Aneurysm
Treatments for brain aneurysm before or after bursting use the same procedures. The difference is that treatment before an aneurysm bursts can prevent brain damage, disability and save a life.
A burst aneurysm is a medical emergency and requires prompt treatment to stop the bleeding and minimize brain damage. For a small aneurysm, observation is often safest and allows treatment when the risk of rupture has increased. Other aneurysm treatments require neurosurgery and interventional neuroradiology and include:
- Microvascular clipping – An open surgery procedure, a neurosurgeon places a metal clip at the base of the aneurysm to close it off from normal blood flow.
- Coiling – Also called endovascular coiling, or coil embolization, this less-invasive procedure uses an image-guided catheter to fill the aneurysm with platinum wire, preventing blood from entering and bursting the aneurysm.
- Flow diversion stents – A stent, a flexible mesh tube like those used for opening clogged heart arteries, is placed at the base of the aneurysm to block blood flow to the bulging aneurysm. This procedure treats large aneurysms and aneurysms that can't be treated by clipping or coiling.
Brain Aneurysm Risk Factors
Risk factors for developing a brain aneurysm include:
- Family history
- Connective tissue disorders that weaken artery walls
- Polycystic kidney disease
- Arteriovenous malformations
- Head trauma
- Brain tumor
Risk factors for aneurysm rupture include:
- Smoking tobacco
- High blood pressure – damages and weakens arteries
- Size – the largest aneurysms are most likely to rupture
- Location in the brain
- Cocaine, amphetamines or other drugs that increase blood pressure
Our neurosurgeons are researching ways to advance the treatment of aneurysms. We participate in several research studies and will soon start a pilot multicenter trial for the treatment of small aneurysms.
Schedule an Appointment
To schedule an appointment with an aneurysm specialist, please call 410-328-4323.