In short,
- Surgery for an aneurysm in the brain can prevent rupture and subsequent brain damage.
- Individuals with specific aneurysm characteristics benefit most from surgical intervention.
- Consult a neurosurgeon to determine if surgery is the best course of action.
What is a Brain Aneurysm?
A brain aneurysm is a bulge in a blood vessel in the brain, and can sometimes require surgery. This weakened area can rupture, causing bleeding into the brain (hemorrhagic stroke). Aneurysms often occur in the circle of Willis at the base of the brain and vary in size.
Prevalence and Risk Factors
An estimated 3% to 5% of the population has a brain aneurysm, meaning about 1 in 30 to 1 in 50 people. The risk of rupture depends on size, location, shape, and individual risk factors.
- Risk factors include smoking, high blood pressure, and family history.
- Genetic conditions like Ehlers-Danlos syndrome can increase risk.
Causes and Risk Factors for Brain Aneurysms
Aneurysms can be present at birth (congenital) due to weakened blood vessel walls, sometimes linked to genetic disorders like Ehlers-Danlos syndrome. Acquired factors include chronic high blood pressure, smoking, and drug abuse (especially cocaine), which can damage blood vessels.
- Age and gender are risk factors; aneurysms are more common in adults and women.
- Having a family history of aneurysms increases your risk.
What are the Symptoms and Warning Signs of a Brain Aneurysm?
Most unruptured aneurysms don’t cause symptoms. However, large aneurysms may press on nerves, causing localized headaches. A ruptured aneurysm is a medical emergency. Symptoms include a sudden, severe headache (“the worst headache of my life”), nausea, vomiting, and a stiff neck. Loss of consciousness and seizures can also occur.
Seek medical attention for any sudden, unexplained, or persistent headache, especially if you also experience neurological symptoms like changes in vision or speech.
Diagnosis and Testing for Brain Aneurysms
Diagnosis involves imaging techniques. CT scans can detect bleeding. MRI provides detailed images of the brain and blood vessels. Cerebral angiograms (dye injected into blood vessels) visualize aneurysms. A lumbar puncture (spinal tap) may detect blood in the cerebrospinal fluid. A neurological examination assesses nerve function.
A neurosurgeon interprets the results, considering the aneurysm’s size, location, shape, and the patient’s overall health to determine the best course of treatment.
Treatment Options and Management, Including Surgery for Aneurysm in the Brain
- Surgical clipping involves a craniotomy (opening the skull) to place a metal clip at the base of the aneurysm, blocking blood flow.
- Endovascular coiling is a minimally invasive procedure where a catheter delivers platinum coils to block blood flow within the aneurysm.
- Conservative management (monitoring with imaging) is used for low-risk, unruptured aneurysms, along with blood pressure control and medication.
What to Expect: Surgical Clipping
If surgical clipping is recommended, expect a pre-operative evaluation including blood tests, an EKG, and imaging. The surgery involves making an incision in the scalp and creating a small opening in the skull (craniotomy).
The neurosurgeon carefully locates the aneurysm and places a titanium clip at its base to prevent rupture. After surgery, patients typically spend several days in the intensive care unit (ICU) for close monitoring.
The hospital stay can range from 5 to 10 days, depending on the complexity of the surgery and the patient’s recovery. Full recovery can take several weeks to months, with potential for physical therapy and rehabilitation.
What to Expect: Endovascular Coiling
Endovascular coiling is a less invasive procedure. A catheter is inserted into an artery, usually in the groin, and guided to the aneurysm in the brain. Platinum coils are then deployed into the aneurysm sac, blocking blood flow.
Patients typically stay in the hospital for 1-2 days after the procedure. Recovery is generally faster than with surgical clipping, but follow-up angiograms are needed to ensure the aneurysm remains blocked.
Prevention and Lifestyle Changes to Reduce Aneurysm Risk
Control blood pressure through lifestyle changes (healthy weight, low-sodium diet, exercise) or medication.
- Avoid drug abuse, especially stimulants.
- Limit alcohol consumption.
- Manage stress.
- Regular check-ups are also important.
- Quitting smoking is crucial. Smoking damages blood vessels and increases aneurysm risk. Seek support from a healthcare provider or a smoking cessation program.
When to Seek Professional Care Regarding Surgery for an Aneurysm in the Brain in Denver
When to Seek Immediate Care
Seek immediate medical attention if you experience any of the following symptoms, as they may indicate a ruptured aneurysm:
- Sudden, severe headache (“the worst headache of my life”)
- Stiff neck
- Nausea and vomiting
- Sensitivity to light
- Blurred or double vision
- Seizures
- Loss of consciousness
Seek immediate medical attention for a sudden, severe headache. Seek prompt medical attention for new or worsening neurological symptoms (changes in vision, speech, coordination, weakness, numbness, seizures).
If you have a diagnosed aneurysm, schedule regular follow-up appointments with a neurosurgeon to monitor the aneurysm and discuss treatment options. Discuss treatment options and potential risks with your doctor.
Questions to Ask Your Doctor When You Get Care
- What is the size and location of my aneurysm?
- What is the risk of rupture for my aneurysm?
- What treatment options are available, and what are the risks and benefits of each?
- How often should I have follow-up imaging to monitor my aneurysm?
- What lifestyle changes can I make to reduce my risk of rupture?
Common Misconceptions
- Misconception:All brain aneurysms require immediate surgery.
- Reality:Many small, unruptured aneurysms can be safely monitored with regular imaging. Surgery is typically recommended for aneurysms at higher risk of rupture.
- Misconception:Endovascular coiling is a permanent solution for all aneurysms.
- Reality:Some aneurysms may require retreatment after coiling to ensure continued blockage of blood flow.
- Misconception:Brain aneurysm surgery always results in significant neurological deficits.
- Reality:While there are risks associated with any surgery, modern techniques and experienced neurosurgeons can minimize the risk of complications.
Surgery for Aneurysm in the Brain in Lone Tree, Colorado Springs, Aurora, & Castle Rock, CO
At Front Range Spine and Neurosurgery, our experienced team provides personalized care, no matter how complex your needs might be. We look at each patient from an individualized perspective and are with you at every step of your care journey. Trust our board-certified neurosurgeons for surgery for an aneurysm in the brain.
Call us today at (303) 790-1800 or use our online appointment request form.
