Contact The Center For Cerebrovascular Diseases
To schedule an appointment with a physician in the Brain Aneurysm Program at the Center for Cerebrovascular Diseases, please contact our Patient Coordinator at: 732-6600. We see new patients with unruptured aneurysms as soon as the next business day.
If you are a physician seeking to refer a patient to the Center for Cerebrovascular Diseases, please call 732-6600 or you can access our physicians office phone numbers. To contact one of our physicians with a question, patient referral or second opinion, you may also email: .
Ucla Cerebrovascular Neurosurgeon Brain Aneurysm Publications
How Can A Brain Aneurysm Growth Or New Aneurysm Formation Be Prevented
Once an aneurysm is found, it is not expected to resolve on its own. However, aneurysm growth, change, risk of aneurysm rupture, or new aneurysm formation can be reduced by having a healthy lifestyle. Steps you can take include:
- Exercise regularly without excessive heavy lifting.
- Eat a balanced diet.
- Get help for alcohol or drug use disorder and dont use cocaine or other stimulant drugs.
- Control high blood pressure with medications and lifestyle changes.
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What Is A Brain Aneurysm
A brain aneurysm, also known as a subarachnoid hemorrhage , is a weak spot in the wall of a blood vessel inside the brain. Think of a weak spot in a balloon and how it feels stretched out and thin. A brain aneurysm is like that.
That area of the blood vessel gets worn out from constant flow of blood and bulges out, almost like a bubble. It can grow to the size of a small berry. There are different types:
Saccular aneurysms are the most common type of brain aneurysm. They bulge out in a dome shape from the main artery. Theyâre connected to that artery by a narrow âneck.â
Fusiform aneurysms arenât as common as saccular aneurysms. They donât pouch out in a dome shape. Instead, they make a widened spot in the blood vessel.
Although brain aneurysms sound alarming, most donât cause symptoms or health problems. You can enjoy a long life without ever realizing that you have one. But in rare cases, aneurysms can grow big, leak, or explode. Bleeding in the brain, known as a hemorrhagic stroke, is serious, and youâll need medical care right away.
Who Should Get Treatment For A Brain Aneurysm
A leaking or ruptured brain aneurysm requires emergency surgery. But you might only find out about a brain aneurysm when you have an imaging test for an unrelated condition.
If you have a small brain aneurysm that isnt causing symptoms, and you do not have other relevant risk factors, your healthcare provider may recommend not treating it. Instead, your provider will order regular imaging tests to rule out any change or growth over time. They will also recommend you quit smoking and require that your blood pressure control is under control. Youll need to get help right away if you develop symptoms, or aneurysm change/growth occurs on follow-up imaging.
If you have symptoms, positive risk factors, and/or the aneurysm is large, you and your healthcare provider will discuss the benefits, risks and alternatives of surgical and/or endovascular treatment. The decision depends on several factors, including but not limited to your:
- Risk of a brain bleed
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What Are Future Directions For The Treatment Of Brain Aneurysm
For those who survive an initial aneurysm rupture, blood vessel spasm may be the villain in causing continued brain damage. Experiments to develop new drugs to control vasospasm are ongoing. Molecules that can cause spasm are being identified, and antibodies may be able to be produced to blunt their effect.
Studies are also looking at the possibility that brain aneurysms may be hereditary, and perhaps screening of high-risk populations may be possible in the future.
How Is Brain Aneurysm Diagnosed
The diagnosis of brain aneurysm begins with a high index of suspicion by the health care practitioner. The history of the headache, an acute onset of the headache, associated with a stiff neck and an ill-appearing patient on physical examination, typically lead the health care practitioner to consider the diagnosis and order a CT scan of the head. If the CT scan is performed within 72 hours of the onset of the headache, it will detect 93% to 100% of all aneurysms. In the few cases that are not recognized by CT, the health care practitioner may consider performing a lumbar puncture to identify blood in the cerebrospinal fluid that runs in the subarachnoid space. Some hospitals will consider CT angiography of the brain instead of the LP.
If the CT or the LP reveals the presence of blood, angiography is performed to identify where the aneurysm is located and to plan treatment. Angiography, where a catheter is threaded into the arteries of the brain and dye is injected while pictures are taken, can demonstrate the anatomy of the arteries and uncover the presence and location of an aneurysm. CT angiography or MR angiography may be performed without threading catheters into the brain as is the case with a formal angiogram. There is some controversy as to which type of angiogram is best to assess the patient, and the kind chosen depends upon the patient’s situation and condition.
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What Should I Do If I Have An Unruptured Cerebral Aneurysm
If you have an unruptured brain aneurysm, its important to talk to your healthcare provider about your treatment and management options. You and your provider may decide its best to closely monitor it and manage medical conditions that can further weaken the blood vessel, or you may decide early treatment makes the most sense. Your healthcare provider will take into account several factors including the aneurysms:
- Risk of rupture.
The Warning Signs Of A Brain Aneurysm
The symptoms and signs of a ruptured aneurysm include:
- A severe headache that comes out of nowhere
- Blurred vision
- Drooping eyelids
- Passing out
An unruptured aneurysm might not initially have any symptoms, but that usually changes as it grows larger. The warning signs that indicate a person has developed an unruptured brain aneurysm include:
- Pain behind or above an eye
- Double vision
- Numbness on one side of the patient’s face
Patients are advised to seek immediate medical attention if:
- They have a severe headache that is incomparable in pain to past headaches suddenly occurs
- They have a seizure
- They lose consciousness
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What Are The Risk Factors For Brain Aneurysm
Inherited risk factors associated with aneurysm formation may include the following:
Acquired risk factors associated with aneurysm formation may include the following:
Atherosclerosis. A buildup of plaque in the inner lining of an artery
Although these risk factors increase a person’s risk, they do not necessarily cause the disease. Some people with one or more risk factors never develop the disease, while others develop disease and have no known risk factors. Knowing your risk factors to any disease can help to guide you into the appropriate actions. These include changing behaviors and being monitored for the disease.
Brain Aneurysm | Brianna’s Story
California teenager Brianna Atkins faced the reality of a life-threatening brain aneurysm with little hope for treatment options. Neurosurgeon Alexander Coon, M.D., drew upon his expertise to provide a unique method for treatment. He used an innovative, minimally invasive flow diversion approach that gave Brianna the chance to lead a normal life.
Are There Warning Signs Of A Brain Aneurysm
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Then, what is an aneurysm of the carotid artery?
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What are the symptoms of an unruptured aneurysm?
Symptoms of an unruptured brain aneurysm can include:
- visual disturbances such as loss of vision or double vision.
- pain above or around your eye.
- numbness or weakness on one side of your face.
- difficulty speaking.
- difficulty concentrating or problems with short-term memory.
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Are There Any Warning Signs Before A Brain Aneurysm
The ballooning of a blood vessel located in the brain is called a brain aneurysm. It leads to a bulge developing in the blood vessel, and this can rupture or leak in the brain, causing a type of hemorrhagic stroke known as a subarachnoid hemorrhage.
A ruptured brain aneurysm is a life-threatening condition that requires immediate medical care. Brain aneurysms are typically the result of thinning artery walls. They usually form at branches or forks in arteries since these are the weakest parts. They can develop on any part of the brain but typically at the base.
Most people develop brain aneurysms that do not rupture, so they do not lead to any health issues. These types of aneurysms are typically detected while the patient is being tested for some other condition.
Treating a brain aneurysm that has not ruptured might prevent a life-threatening condition from occurring in the future. Each patient’s circumstances are unique, so the doctor will advise them on the best way to proceed if an unruptured aneurysm is detected.
How Do Doctors Diagnose A Brain Aneurysm
A brain aneurysm may cause symptoms such as headaches or double vision. Many times, they cause no symptoms at all. Because of this, doctors often are first alerted to a brain aneurysm through an imaging scan you might get for a completely different reason.
Doctors use multiple tests to confirm a brain aneurysm diagnosis:
- MRA: A magnetic resonance angiogram scan is a type of MRI scan that’s specifically for blood vessels.
- CTA: This is a special type of CT scan that focuses on the blood vessels.
- Angiogram: For a traditional angiogram, doctors insert a catheter into your body to see your blood vessels more clearly. It’s the gold standard for diagnosing brain aneurysms because it gives a 3-D view of an aneurysm, offering precise details that help determine the best treatment for you.
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What Causes Brain Aneurysms To Bleed
Researchers havent discovered exactly what causes an aneurysm to leak or rupture, which causes bleeding in or around the brain. But anything that increases your blood pressure can be dangerous. Higher blood pressure makes blood push harder against blood vessel walls. Things that may increase blood pressure include:
- Ongoing stress or a sudden burst of anger or other strong emotion.
- Working hard to lift, carry or push something heavy like weights or furniture.
- Known high blood pressure that is not treated appropriately with medications.
Why Is A Subarachnoid Hemorrhage Life
If a brain aneurysm ruptures or an artery that passes over the surface of the brain bursts, blood flows into the fluid-filled space around the brain. Doctors call this area the “subarachnoid space.” Bleeding into this space is called a subarachnoid hemorrhage.
Blood can then quickly spread in this space and put pressure on the whole brain. This means that even parts of the brain that aren’t very close to the bleeding blood vessel are damaged. The bleeding quickly causes a severe headache. Left untreated, it often leads to unconsciousness and life-threatening complications like an irregular heartbeat and respiratory arrest .
The brain damage can cause long-term or permanent problems in everyday life, or lead to the need for nursing care for instance because of speech problems or paralysis.
Different types of bleeding in the brain
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What Does The Beginning Of A Brain Aneurysm 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 Is An Aneurysm Diagnosed
Special imaging tests can detect a brain aneurysm. In the CTA , patients are placed on a table that slides into a CT scanner. A special contrast material is injected into a vein, and images are taken of the blood vessels to look for abnormalities such as an aneurysm. In the second test, called MRA , patients are placed on a table that slides into a magnetic resonance scanner, and the blood vessels are imaged to detect a cerebral aneurysm.
The most reliable test is called a diagnostic cerebral angiogram. In this test, the patient lies on an X-ray table. A small tube is inserted through a blood vessel in the leg and guided into each of the blood vessels in the neck that go to the brain. Contrast is then injected, and pictures are taken of all the blood vessels in the brain. This test is slightly more invasive and less comfortable.
Beforeanytreatment is considered, a diagnostic cerebral angiogram is usually performed to fully map a plan for therapy.
If one aneurysm forms, will others form? Having one aneurysm means theres about a 20 % chance of having one or more other aneurysms.
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What Are The Risk Factors For A Brain Aneurysm
About five million people in the United States have some form of brain aneurysm. Common risk factors that contribute to having or rupturing an aneurysm are smoking and high blood pressure. Other contributors are atherosclerosis, use of illicit drugs, and alcohol consumption . One less controllable risk factor is family history of aneurysms, suggesting a yet-undiscovered genetic basis. Anyone with a family history of aneurysms is recommended to undergo screening every 5 to 10 years.
Risk of rupture also depends the size and shape of the aneurysm, among many other variables. Expert and prompt evaluation, and treatment if needed, can decrease the risk of rupture.
In this video, Rose Du, MD, PhD, Director of Cerebrovascular Surgery discusses brain aneurysm risk factors, the decision of whether to treat an aneurysm, and what types of treatments are available.
What Causes Brain Aneurysms
Most aneurysms are acquired. However, they are more common in people with certain genetic diseases, such as connective tissue disorders and polycystic kidney disease, and certain circulatory disorders. Other causes include trauma or injury to the head, high blood pressure, infection, tumors, atherosclerosis and other diseases of the vascular system, cigarette smoking, and drug abuse.
Fusiform aneurysms are less common. They consist of an outpouching of the arterial wall. There is no stem.
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How Are Brain Aneurysms Treated
Surgery and/or endovascular therapy are the treatment for brain aneurysms, whether they are ruptured or unruptured.
Open surgical clipping
During this procedure, your surgeon cuts a small opening in your skull to access the aneurysm. Using a tiny microscope and instruments, your surgeon attaches a small metal clip at the base of the aneurysm to pinch it off. This blocks blood from flowing into the aneurysm. The surgery can stop a brain bleed or keep an intact aneurysm from breaking open. Recovery time is different for ruptured and unruptured aneurysms. This procedure is considered to be durable with a low recurrence rate.
For this procedure, your surgeon doesnt need to create an opening in your skull. Instead, a doctor inserts a catheter in a blood vessel, usually in the groin or wrist, and threads it to your brain.
Through the catheter, your doctor places a ball of wires , most often made of platinum, in the aneurysm, sometimes with the help of small stents or balloons. Recently another small device , which looks like a mesh ball, made of nickel titanium, also became available, and works in a similar fashion as coils. Both methods result in blood clot formation around and inside the wire ball or web device, and block blood flow into the aneurysm, reducing or eliminating the risk of rupture.
What Is A Cerebral Aneurysm
A cerebral aneurysm is a weak or thin spot on an artery in the brain that balloons or bulges out and fills with blood. The bulging aneurysm can put pressure on the nerves or brain tissue. It may also burst or rupture, spilling blood into the surrounding tissue . A ruptured aneurysm can cause serious health problems such as hemorrhagic stroke, brain damage, coma, and even death.
Some cerebral aneurysms, particularly those that are very small, do not bleed or cause other problems. These types of aneurysms are usually detected during imaging tests for other medical conditions. Cerebral aneurysms can occur anywhere in the brain, but most form in the major arteries along the base of the skull.
Brain aneurysms can occur in anyone and at any age. They are most common in adults between the ages of 30 and 60 and are more common in women than in men. People with certain inherited disorders are also at higher risk.
All cerebral aneurysms have the potential to rupture and cause bleeding within the brain or surrounding area. Approximately 30,000 Americans per year suffer a brain aneurysm rupture. Much less is known about how many people have cerebral aneurysms, since they dont always cause symptoms. There are no proven statistics but a consensus of scientific papers indicate that between 3 and 5 percent of Americans may have an aneurysm in their lifetime.
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