What Is a Cerebral Aneurysm?
A cerebral aneurysm is a weak spot on one of the arteries of the brain that balloons out and has the potential to rupture. Cerebral aneurysms are most frequently detected between the ages of 35 and 60 and are more common in women than men. They may be detected prior to rupturing with imaging studies such as MR angiography (MRA), CT angiography (CTA), or conventional cerebral angiography.
A ruptured brain aneurysm is a medical emergency and causes bleeding into the fluid surrounding the brain (called the subarachnoid space). Half of patients die within thirty days of rupture, and of those patients that survive, half suffer from significant neurological impairment. Once an aneurysm ruptures, it is almost always treated emergently. However, if an aneurysm is detected prior to rupturing, it may be treated electively with surgery or coiling, though some aneurysms are left untreated. Decisions regarding treatment should be made after discussions with specialists including an Interventional Neuroradiologist and a Neurosurgeon.
Surgery is performed by a Neurosurgeon and involves removing a piece of bone from the skull, spreading apart the brain to expose the aneurysm, and placing a metal clip across the neck of the aneurysm before replacing the bone. Coiling is a less invasive method of treating cerebral aneurysms and is performed by an Interventional Neuroradiologist. A catheter (small plastic tube) is placed in the femoral artery located in the groin region and is advanced to the aneurysm using X-ray guidance (fluoroscopy). Once in the aneurysm, small coils made of platinum or other devices are threaded through the catheter and are placed into the aneurysm. This prevents or decreases blood flow entering the aneurysm and protects it from rupturing in the future.