When And Why A Brain Aneurysm Requires Surgery
A brain aneurysm is a balloon-like bulge in a blood vessel that can potentially burst. Between 1.5 and 5 percent of people have or develop a brain aneurysm, according to the American Stroke Association.
Given the diagnosis, Mureddu and her husband, Chuck, went online to the Brain Aneurysm Foundation and found an experienced surgeon at Massachusetts General Hospital in Boston for the operation. But it would be another month until she was wheeled into the operating room.
Her surgeon explained that when she had felt pain in her head, the aneurysm had bled. He didnt expect it to bleed again in the next four weeks, and he needed the time to study the best way to proceed with the surgery. Mureddus aneurysm was considered giant at 3.1 centimeters. Any aneurysm over 2.5 centimeters one inch is termed giant, according to MGHs Neurovascular Center. Hers also had veins going through it, which meant the surgeon wouldnt be able to just clip it off. He would have to do two bypasses.
Although she’d had no symptoms until that day at the gym, her doctors suspected Mureddu had had the brain aneurysm for some time.
She had a history of 23 years of migraines, she says. I would get 12 to 18 migraines a month where I would get sick. But I lived in three states during those 23 years, and no one ordered a scan of my head.
Why Brain Aneurysms Develop
Exactly what causes the wall of affected blood vessels to weaken is still unclear, although risk factors have been identified.
- high blood pressure
- a family history of brain aneurysms
In some cases, an aneurysm may develop because there was a weakness in the walls of the blood vessels at birth.
What Are The Complications Of A Ruptured Cerebral Aneurysm
Aneurysms may rupture and bleed into the space between the skull and the brain and sometimes into the brain tissue . These are forms of stroke called hemorrhagic stroke. The bleeding into the brain can cause a wide spectrum of symptoms, from a mild headache to permanent damage to the brain, or even death.
After an aneurysm has ruptured it may cause serious complications such as:
- Rebleeding. Once it has ruptured, an aneurysm may rupture again before it is treated, leading to further bleeding into the brain, and causing more damage or death.
- Change in sodium level. Bleeding in the brain can disrupt the balance of sodium in the blood supply and cause swelling in brain cells. This can result in permanent brain damage.
- Hydrocephalus. Subarachnoid hemorrhage can cause hydrocephalus. Hydrocephalus is a buildup of too much cerebrospinal fluid in the brain, which causes pressure that can lead to permanent brain damage or death. Hydrocephalus occurs frequently after subarachnoid hemorrhage because the blood blocks the normal flow of cerebrospinal fluid. If left untreated, increased pressure inside the head can cause coma or death.
- Vasospasm. This occurs frequently after subarachnoid hemorrhage when the bleeding causes the arteries in the brain to contract and limit blood flow to vital areas of the brain. This can cause strokes from lack of adequate blood flow to parts of the brain.
Are Brain Aneurysms Painful
Most people who have an unruptured brain aneurysm dont even know its there. It usually doesnt cause pain or any symptoms at all.
However, many smaller aneurysms are actually found when investigating causes of chronic headache. Researchers don’t know for sure if headaches are directly related to an unruptured aneurysm. One thought is that the swollen blood vessel is pressing into the nerves and membranes/tissues around the brain, causing the headache.
A sudden, severe headache can be a sign of a ruptured aneurysm. Rarely, you can also have a headache that lasts for days or weeks from an aneurysm thats leaking a small amount of blood. This type of lingering headache is called a sentinel headache. Its a warning that the aneurysm is about to burst.
Can Aneurysms Be Cured Without Surgery
Treatment with a catheter is done without open surgery. The patient is given an anesthetic. The catheter is inserted into an artery in the groin and then moved up into the blood vessel in the brain that has the aneurysm. The doctor can then place small platinum coils in the aneurysm through the catheter.
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How Do You Prevent An Aneurysm From Bursting
If you have an unruptured brain aneurysm, you may lower the risk of its rupture by making these lifestyle changes:Dont smoke or use recreational drugs. If you smoke or use recreational drugs, talk to your doctor about strategies or an appropriate treatment program to help you quit.Eat a healthy diet and exercise.Aug 9, 2019
What Causes A Cerebral Aneurysm
Cerebral aneurysms form when the walls of the arteries in the brain become thin and weaken. Aneurysms typically form at branch points in arteries because these sections are the weakest. Occasionally, cerebral aneurysms may be present from birth, usually resulting from an abnormality in an artery wall.
Risk factors for developing an aneurysm
Sometimes cerebral aneurysms are the result of inherited risk factors, including:
- genetic connective tissue disorders that weaken artery walls
- polycystic kidney disease
- arteriovenous malformations
- history of aneurysm in a first-degree family member .
Other risk factors develop over time and include:
- untreated high blood pressure
- cigarette smoking
- drug abuse, especially cocaine or amphetamines, which raise blood pressure to dangerous levels. Intravenous drug abuse is a cause of infectious mycotic aneurysms.
- age over 40.
Less common risk factors include:
- head trauma
- brain tumor
- infection in the arterial wall .
Additionally, high blood pressure, cigarette smoking, diabetes, and high cholesterol puts one at risk of atherosclerosis , which can increase the risk of developing a fusiform aneurysm.
Risk factors for an aneurysm to rupture
Not all aneurysms will rupture. Aneurysm characteristics such as size, location, and growth during follow-up evaluation may affect the risk that an aneurysm will rupture. In addition, medical conditions may influence aneurysm rupture.
Risk factors include:
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Are Migraines Linked To Aneurysms
Migraine headaches don’t cause aneurysms to form or burst. And they aren’t a sign that you’re about to have a burst aneurysm.
Studies show that some people with an aneurysm that hasn’t burst may get migraines in the weeks and months before it bursts. But there’s no evidence that migraines and aneurysms happen at the same time.
Some research suggests that people who get migraines have a greater risk for a brain aneurysm, but more study is needed.
How Do You Treat An Aneurysm Naturally
11 Tips to Help Reduce Your Risk of an AneurysmMake Healthy Choices in Your Diet. Keep Your Blood Pressure Levels in Check. Lower High Cholesterol. Make Exercise a Part of Your Routine. Take Steps to Reduce and Manage Stress Well. 10 Tips to Help You De-Stress. Treat Obstructive Sleep Apnea. Quit Smoking.More itemsMay 7, 2018
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Getting Ready For The Treatment Or Surgery
Depending on the analysis results, the doctor will inform about the treatment or the surgical procedure in detail. It is necessary to follow the instructions to ensure that the individual is ready for the treatment or surgery. About 80% of the cases involve correction of the diet and placing the patient under observation. It is because not all aneurysms rupture leading to the requirement of surgery.
Where Does Your Head Hurt If You Have A Brain Aneurysm
A headache brought on by a brain aneurysm can make your head feel like its going to implode. They also typically occur suddenly, rather than taking time to build up. You should also see a doctor if you have pain above and behind an eye, dilated pupils, drooping eyelid or paralysis on one side of the face.
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How Are Cerebral Aneurysms Treated
Not all cerebral aneurysms require treatment. Some very small unruptured aneurysms that are not associated with any factors suggesting a higher risk of rupture may be safely left alone and monitored with MRA or CTA to detect any growth. It is important to aggressively treat any coexisting medical problems and risk factors.
Treatments for unruptured cerebral aneurysms that have not shown symptoms have some potentially serious complications and should be carefully weighed against the predicted rupture risk.
Treatment considerations for unruptured aneurysms A doctor will consider a variety of factors when determining the best option for treating an unruptured aneurysm, including:
- type, size, and location of the aneurysm
- risk of rupture
- the persons age and health
- personal and family medical history
- risk of treatment.
Individuals should also take the following steps to reduce the risk of aneurysm rupture:
- carefully control blood pressure
- avoid cocaine use or other stimulant drugs.
Treatments for unruptured and ruptured cerebral aneurysms Surgery, endovascular treatments, or other therapies are often recommended to manage symptoms and prevent damage from unruptured and ruptured aneurysms.SurgeryThere are a few surgical options available for treating cerebral aneurysms. These procedures carry some risk such as possible damage to other blood vessels, the potential for aneurysm recurrence and rebleeding, and a risk of stroke.
Visit The Er If You Notice These Symptoms
While most brain aneurysms cause no symptoms, individuals with large brain aneurysms that have not yet ruptured may experience severe localized headaches, blurred vision, changes in speech and neck pain, depending on the size and location of the aneurysm.
The following symptoms of a ruptured brain aneurysm often come on quickly and individuals experiencing these symptoms should seek medical attention immediately:
- Sudden severe headache that is different from previous headaches
- Loss of consciousness
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What Are The Causes
Studies have shown a strong link to family history . If an immediate family member has suffered an aneurysm, you are 4 times more likely to have one as well. The genetic link is not completely understood and studies are underway to determine if there is a pattern of inheritance. The most important inherited conditions associated with aneurysms include Ehlers-Danlos IV, Marfans syndrome, neurofibromatosis NF1, and polycystic kidney disease. For those with a strong family history of aneurysm in two or more blood relatives, we recommend a screening test with a CT or MR angiogram.
Traditional Surgical Treatment For A Cerebral Aneurysm
With this approach, surgery is done to clip the aneurysm. First a window is made in the skull. This is called a craniotomy. This allows the surgeon to get inside the skull to find the aneurysm. Aneurysms usually occur just under the brain or between the lobes of the brain. It isn’t usually necessary to cut into the brain to remove the aneurysm.
Once the aneurysm is exposed and dissected, a small, hinged aneurysm clip is placed on the neck of the aneurysm to seal off the weakened part of the artery.
For small aneurysms, this surgery can be done safely with a relatively low risk of complications. The risks are greater – 30% or more – for aneurysms that are complex, an inch or larger or located in the back part of the brain.
Sometimes more complex surgery, such as cerebral artery bypass or deliberate cardiac standstill are needed for more complex aneurysms.
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Safety And Common Complications
Although the frequencies of certain complications vary according to the intervention, both clipping and coiling share the same complications. Rupture of the aneurysm is one of the most serious complications seen in either procedure. Exact frequencies of ruptures are not well documented, but reported rupture rates range from 2 percent to 3 percent for both coiling and clipping. Rupture can cause massive intracerebral hemorrhage and subsequent coma or death. Although rupture can have catastrophic consequences during either procedure, surgery probably provides a better opportunity to control hemorrhage because of direct access to the ruptured aneurysm and the supplying vessels.
Ischemic stroke is another serious complication frequently encountered in both clipping and coiling. The pattern and distribution of strokes varies according to the aneurysm location and procedure type.
The actual length of the procedure, the associated risks, the projected recovery time and the expected prognosis depend on both the location of the aneurysm, the presence/severity of hemorrhage and the patient’s underlying medical condition. Therefore, each individual case should be discussed with the treating neurosurgeon/physician.
When Did My Mom Have A Brain Aneurysm
It was January 12, 1988. As I rushed around getting ready for school, my mom helped me study for my vocabulary test as we bumped into each other as we tried to share the bathroom sink she was impressed that I knew all of the words on our first run-through, so we eliminated additional studying from that mornings task list.
Will I Need Surgery To Treat An Unruptured Brain Aneurysm
For an unruptured brain aneurysm, your doctor will decide whether it’s better to treat the aneurysm now or monitor you carefully .
Certain aneurysms are more likely to bleed, or rupture. A rupture is a critical and potentially life-threatening situation. Your care team will determine how likely the aneurysm is to rupture so it can plan your treatment.
If treatment is necessary, your doctor will consider which treatment is best for your circumstances. The two most effective treatments for brain aneurysms today are:
- Microsurgical clipping: Neurosurgeons make a small opening in the skull and place a titanium clip to prevent blood from flowing into an aneurysm.
- Endovascular coiling: In this newer approach, neurosurgeons place a stent, or tube, or other devices, such as coils, inside a blood vessel or aneurysm to divert blood flow away from an aneurysm.
What Is A Ruptured Aneurysm
An aneurysm is a balloon-like bulge or weakening of an artery wall. As the bulge grows it becomes thinner and weaker. It can become so thin that the blood pressure within can cause it to leak or burst open. Aneurysms usually occur on larger blood vessels at the fork where an artery branches off. Types of aneurysms include :
- Saccular – the aneurysm bulges from one side of the artery and has a distinct neck at its base.
- Fusiform – the aneurysm bulges in all directions and has no distinct neck.
- Dissecting – a tear in the inner wall of the artery allows blood to split the layers and pool often caused by a traumatic injury.
When an aneurysm bursts, it releases blood into the spaces between the brain and the skull. This space is filled with cerebrospinal fluid that bathes and cushions the brain. As blood spreads and clots it irritates the lining of the brain and damages brain cells. At the same time, the area of brain that previously received oxygen-rich blood from the affected artery is now deprived of blood, resulting in a stroke. A subarachnoid hemorrhage is life threatening with a 40% risk of death.
Enclosed within the rigid skull, clotted blood and fluid buildup increases pressure that can crush the brain against the bone or cause it to shift and herniate. Blockage of the normal CSF circulation can enlarge the ventricles causing confusion, lethargy, and loss of consciousness.
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What Does A Brain Aneurysm Headache Feel Like
Symptoms of a ruptured brain aneurysm usually begin with a sudden agonising headache. Its been likened to being hit on the head, resulting in a blinding pain unlike anything experienced before. Other symptoms of a ruptured brain aneurysm also tend to come on suddenly and may include: feeling or being sick.
How Do I Decide What Procedure To Have If I Have A Cerebral Aneurysm
The treatment of choice for an intracranial aneurysm, like all medical decisions, should be agreed upon by both the physician and the patient. In the case of either ruptured or un-ruptured intracranial aneurysms, the treating physician should discuss the risks and benefits of each available treatment option. The physician will usually make recommendations for one treatment over another, depending on the facts of each individual case. Seeking a second opinion, when possible, is usually advisable.
Although unresolved controversies remain as to what the best treatment option is for an individual patient, both surgical clipping and endovascular coiling/stenting are considered to be viable treatment options in the management of cerebral aneurysms today.
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What’s The Difference Between A Ruptured And An Unruptured Brain Aneurysm
A ruptured aneurysm, sometimes called a brain bleed, is when blood breaks through the aneurysm’s wall and starts bleeding. This causes severe symptoms, such as a very painful headache like you’ve never felt before, and requires immediate medical care. With rapid, expert treatment, patients can often recover fully.
An unruptured brain aneurysm may cause zero symptoms. People can live with them for years before detection. If a brain aneurysm is unruptured, no blood has broken through the blood vessel walls. This means the “balloon” in your blood vessel remains intact.
For unruptured brain aneurysms, doctors will treat aneurysms that are more likely to bleed and leave certain others alone.
Once a brain aneurysm bleeds, or ruptures, it requires immediate medical care in a medical center designed to handle emergencies. If you think you are experiencing a ruptured brain aneurysm, dial 911 immediately.
Neurosurgeons use specialized procedures to treat ruptured and unruptured brain aneurysms, when appropriate:
- Microsurgical clipping: Neurosurgeons make a small opening in the skull and then place a titanium clip over the aneurysm to stop blood flow into the aneurysm.
- Endovascular coiling/stenting: In this newer approach, neurosurgeons place a stent, or tube, or other devices, such as coils, inside a blood vessel or aneurysm to divert blood flow away from an aneurysm.