A cerebral or intracranial aneurysm, also referred to as a brain aneurysm, is a weakening in the wall of a blood vessel that resembles a balloon or even a berry. These aneurysms may grow and burst, causing a bleed into the brain known as a subarachnoid hemorrhage (SAH). In fact, over 90% of SAH’s are caused by brain aneurysms. SAH’s are an emergency, life threatening condition which requires prompt medical and surgical treatment by a neurosurgeon. Approximately 30,000 people in the United States suffer a ruptured brain aneurysm each year.

Not all brain aneurysms rupture or bleed, and are referred to as “incidental aneurysms” when discovered before they have caused any symptoms. Brain aneurysms vary tremendously in size, and larger aneurysms or an aneurysms which are growing may pose a greater risk of rupturing. It may be recommended that a neurosurgeon treat these aneurysms before they cause a problem, which is known as prophylactic treatment. 

Examples of other risk factors which may increase the risk of complications from brain aneurysms include:

  • High Blood Pressure (Hypertension)
  • Cigarette Smoking
  • Diabetes
  • Strong Family History of Brain Aneurysms, Brain Injury or Trauma to Blood Vessels
  • Complication from Some Types of Blood Infections

A cerebral or intracranial aneurysm is an abnormal focal dilation of an artery in the brain that results from a weakening of the inner muscular layer (the intima) of a blood vessel wall. The vessel develops a “blister-like” dilation that can become thin and rupture without warning. The resultant bleeding into the space around the brain is called a subarachnoid hemorrhage (SAH). This kind of hemorrhage can lead to a stroke, coma and/or death.

Aneurysms are usually found at the base of the brain just inside the skull, in an area called the subarachnoid space. In fact, 90 percent of SAHs are attributed to ruptured cerebral aneurysms and the two terms are often used synonymously.

Aneurysms range in size, from small (about 1/8 inch) to nearly one inch. Aneurysms larger than one inch are called giant aneurysms, pose a particularly high risk and are difficult to treat. The exact mechanisms by which cerebral aneurysms develop, grow and rupture are unknown.

However, a number of factors are believed to contribute to the formation of cerebral aneurysms, including:

  • Hypertension (High Blood Pressure)
  • Cigarette Smoking
  • Congenital (Genetic) Predisposition
  • Injury or Trauma to Blood Vessels
  • Complication from Some Types of Blood Infections

Patients with intracranial aneurysms can present with SAH from aneurysmal rupture or with un-ruptured aneurysms, which may have been discovered incidentally or resulted in neurological symptoms. An aneurysm ruptures when a hole develops in the sac of the aneurysm. The hole can be small, in which case only a small amount of blood leaks, or large, leading to a major hemorrhage. An un-ruptured aneurysm is the one whose sac has not previously leaked. Every year approximately 30,000 patients in the U.S. suffer from a ruptured cerebral aneurysm, and up to 6% of the population may have an un-ruptured cerebral aneurysm.

A series of 111 patients with un-ruptured aneurysms showed:

  • 51% with Asymptomatic Aneurysms
  • 17% with Acute Symptomatology, such as Ischemia (37% of Aneurysms)
  • Headache (37% of Aneurysms)
  • Seizures (18% of Aneurysms)
  • Cranial Neuropathies (12% of Aneurysms)
  • Chronic Symptomatology (32%), which included Headache (51%)
  • Visual Deficits (29%)
  • Weakness (11%)
  • Facial Pain (9%)

The management of both ruptured and un-ruptured cerebral aneurysms poses a significant challenge for patients and their treating physicians. Coaxial Neurosurgical Specialists is dedicated to providing the most contemporary treatment approach for brain aneurysms to our patients. Successful patient outcomes are our reward.

Coaxial Neurosurgical Specialists
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