Cerebral Aneurysm

You absorb oxygen and nutrients because of blood vessels that transport blood throughout your body. But these blood vessels aren’t always healthy and sometimes begin to bulge like a balloon. This damage, called a cerebral aneurysm (brain aneurysm), doesn’t always come with brain aneurysm symptoms, though.

Most cerebral aneurysms are only discovered while testing for another condition or during a rupture. An aneurysm that leaks or ruptures blood into the brain (causing a stroke) can cause permanent damage and is potentially life-threatening.

Cerebral aneurysms vary in severity. Some have symptoms that are intense enough to require immediate medical intervention. Others show little to no signs of a brain aneurysm at all and might only be discovered during a routine wellness check.

The three types of aneurysms are:

Leaking Aneurysms

These develop when a small amount of blood leaks out of the blood vessel in the brain. These leaks, also called sentinel bleeds, are rare and are often the warning signs that a rupture is about to happen. Symptoms include severe headache, nausea and vomiting. If you suspect a possible leak, seek medical help immediately.

Ruptured Aneurysms

A ruptured cerebral aneurysm is unmistakable and creates a severely debilitating aneurysm headache. Seek medical help immediately. A ruptured brain aneurysm can lead to heavy blood loss, brain damage and even death.

Unruptured Aneurysms

These are deceivingly mild but are subtle warning signs that you should talk to a medical expert about your symptoms. You may notice changes in vision and pupil appearance, face paralysis and numbness.

Constant pressure from blood flow is what can weaken a blood vessel in the brain and cause it to swell up like a balloon. Typically, this swelling happens slowly. As the blood vessel stretches, it becomes weaker and more likely to leak or burst.

It’s common to wonder if there are any warning signs of a brain aneurysm. Identifying potential brain aneurysm symptoms can be critical to avoiding brain damage, loss of function and even loss of life.

Signs of a brain aneurysm vary depending on the type of aneurysm, and may include:

• Altered vision
• Difficulty with speech
• Eye pain
• Face paralysis
• Heart attack
• Light sensitivity
• Loss of balance
• Loss of consciousness
• Loss of short-term memory
• Nausea
• Numbness
• Pupil dilation
• Seizures
• Stiff neck
• Vomiting
• Weakness

Oftentimes, brain aneurysms are not detected until they rupture or are found during medical imaging tests for other conditions.

If you experience a severe headache or other symptoms of an aneurysm, there are four types of tests your doctor may order to determine if your symptoms are the result of an aneurysm.

Within the AdventHealth Neuroscience Institute network, our doctors use these tests to detect an aneurysm:

Computed Tomography (CT) Scan

Fast and painless, a CT scan is usually the first test ordered for patients with aneurysm symptoms. A CT scan creates 2D images of the brain and skull — sometimes referred to as “slices” — using X-rays.

Sometimes, a contrast dye is injected into the patient’s bloodstream before the CT scan to help locate an aneurysm. This is called a CT angiography (CTA), and it produces sharper and more detailed images of the blood flow in the arteries of the brain. A CTA can clearly determine the size, location and shape of both ruptured and unruptured aneurysms.

Magnetic Resonance Imaging (MRI)

An MRI detects bleeding in the brain by creating 2D and 3D detailed images using computer-generated radio waves and a magnetic field. Magnetic resonance angiography (MRA) produces more detailed images of brain arteries to show the location, shape and size of aneurysms.

Cerebral Angiography

An imaging technique that uses a catheter, X-ray imaging guidance and an injection of contrast material, cerebral angiography can reveal abnormalities, including aneurysms in the blood vessels of the brain. The detail, clarity and accuracy of cerebral angiography can sometimes make it possible for doctors to diagnose and treat an aneurysm in a single procedure, eliminating the need for surgery.

Cerebrospinal Fluid (CSF) Analysis

A clear, colorless liquid, cerebrospinal fluid (CSF) acts as a cushion against sudden impact or injury to the brain or spinal cord. A CSF analysis is a series of tests performed on a sample of that fluid, collected from a lumbar puncture (commonly referred to as a spinal tap). A CSF analysis can detect bleeding in the brain, but additional tests are needed to identify its exact cause.

How to treat an aneurysm will depend on the type of aneurysm, the potential risk of interference and the severity of your condition. Treatment may be as simple as routine monitoring to ensure the aneurysm doesn’t rupture, or as complex as taking aggressive steps like minimally invasive surgery.

Treatment options include:

Flow Diversion Devices

A small, hollow tube called a stent can be inserted into your blood vessel to direct blood away from the aneurysm. This way, your surgeon can avoid entering the aneurysm itself.

Medication

Specific medications — such as anti-seizure medication or ones that reduce heavy blood flow to the brain — may be prescribed by your physician to treat ruptured cerebral aneurysms.

Microvascular Clipping

Your surgeon can perform safe and highly effective brain surgery while you’re awake through microvascular clipping. During this open surgical procedure, a portion of your skull is gently and temporarily removed, and a tiny clip is placed in the affected area to stop blood flow from entering the cerebral aneurysm. Most aneurysms that are clipped do not recur.

Platinum Coil Embolization

Your surgeon can block the leak or rupture and reduce blood flow through platinum coil embolization. In this procedure, a surgeon threads a catheter into the blood vessel toward the cerebral aneurysm. They then insert a tiny platinum wire coil through the catheter to reduce the blood flow.