TYPES OF ANEURYSMS

Unruptured Aneurysms

Small unruptured aneurysms often are asymptomatic. Large unruptured aneurysms may cause symptoms like pain above and behind the eye, numbness, weakness or paralysis on one side of the face, dilated pupil, or vision changes. Doctors must determine whether to treat the aneurysm or monitor it closely. The decision will hinge on likelihood of rupture, size and location, family history, age and health of patient, and whether multiple aneurysms are present.

Ruptured Aneurysms

When brain aneurysms rupture, bleeding usually ensues, which can irritate, damage, or destroy surrounding brain cells. Ruptured brain aneurysms can be fatal. They are considered a medical emergency and require immediate medical intervention. Patients with a ruptured brain aneurysm often report the worst headache of their life, along with nausea and vomiting, stiff neck, blurred or double vision, sensitivity to light, dilated pupils, and/or loss of sensation. 

DIAGNOSIS

Aneurysm diagnosis typically stems from physical examination and ultrasound or CT imaging. Computed Tomographic Angiography (CTA) and Magnetic Resonance Angiography (MRA) are noninvasive options for determining the exact size and location of an aneurysm; however, the gold standard is cerebral catheter angiography, which is considered minimally invasive. 

TREATMENTS

Not all aneurysms require treatment at the time of diagnosis. Your physician may opt to closely monitor your aneurysm instead. Brain aneurysms that do require treatment can be treated through an open surgical procedure or a less invasive endovascular procedure. 

Surgical treatment (clipping) is the traditional treatment for brain aneurysm. One of our skilled neurointerventionalists will open the skull to place a clip across the aneurysm where it balloons out from the blood vessel. This prevents blood flow from entering the aneurysm and significantly reduces the risk of rupture.

Endovascular treatment is performed by a neurointerventionalist, often as an extension of the angiogram, where a catheter is inserted into the groin and navigated through the blood vessels to the brain. Depending on the aneurysm size and location, clinical symptoms, and other factors, the physician will use implants (either coils or flow diverters) to repair the aneurysm. Coiling is a procedure that delivers platinum coils to the aneurysm, blocking blood flow to the aneurysm and reducing the pressure that may otherwise cause it to rupture. For some aneurysms, physicians will insert flow diverters, tightly woven mesh devices that are designed to divert blood away from the aneurysm, thereby excluding it from the blood flow. Flow diverters serve as flexible but supportive scaffolding to reconstruct the artery that contains the aneurysm.