An intracranial (or brain) aneurysm is a weakening of a cerebral artery resulting in a blood-filled outpouching of the vessel. Over time, the pouch can grow and/or the vessel wall can become thinner, leading to the aneurysm to rupture. The rupture causes bleeding in the brain (also known as an intracranial hemorrhage) and can have serious effects, including death. It is believed that between 1 and 4% of the population may have a brain aneurysm without even knowing it.
The incidence of brain aneurysms may also be increasing due to the aging population.
Many aneurysms do not display clinical symptoms and, if unruptured, are often diagnosed by chance. However, in some cases, an unruptured aneurysm can cause symptoms that include but are not limited to:
If any of these signs are present, it is important to seek the guidance of a medical professional.
An aneurysm may rupture due to the thinning of the wall of the blood vessel over time. While this may be due to the aneurysm growing to a large size, aneurysms of any size can rupture. Ruptured aneurysms are extremely dangerous and are associated with very high mortality rates. Symptoms of an aneurysm rupture may include, but are not limited to:
If you or someone near you has any of these symptoms, seek emergent medical attention.
The intensity and constellation of symptoms that a patient experiences from a ruptured aneurysm may depend on the extent of the hemorrhage and its location. The larger the hemorrhage, the more devastating the effects.
When treating any intracranial aneurysm, the objective is to exclude the flow of blood into the aneurysm sac. In the case of patients with unruptured aneurysms, treatment is pursued to prevent the aneurysm from growing over time and potentially rupturing in the future. In the case of a patient with a ruptured aneurysm, the objective is to stop blood flow into the aneurysm and thus protect against a re-rupture event, which carries a grave prognosis. When unruptured aneurysms are identified, the physician may choose not to intervene and rather to observe or monitor the aneurysm over time for growth.
In terms of treatment, there are a few options that may be considered including open surgery (craniotomy) with aneurysm clipping or bypass, or endovascular treatments which may include placement of coils, stents, flow diverters, or intra-aneurysmal occlusion devices.