Treatment Options for Brain Aneurysms

Brain Aneurysms
Brain aneurysms refer to weakness in the walls of blood vessels supplying blood to the brain, leading it to balloon out – and in some cases rupture, creating potentially morbid situations. Brain aneurysms usually create no symptoms up to the point when they rupture and leak blood into the skull resulting in stroke or subarachnoid hemorrhage. The network of blood vessels at the base of the brain are the ones usually involved in aneurysms. The trigger for rupturing of the blood vessel is still unknown but is believed to be some form of stress or the other.

Brain aneurysms aren’t as uncommon as previously thought and about 1.5-5% of the general population has or will develop brain aneurysm. They may occur due to hereditary factors where other family members may have also had it, hardening of the arteries or due to increasing age. They are also more frequent in women and in the African-American race as compared to whites. The risk of subarachnoid hemorrhages is also higher in those with a tendency towards high blood pressure as well as in people who smoke. Also, once a person has had one aneurysm, he/she is likely to have another.

The symptoms of aneurysms are of sudden-onset and include neck pain, sensitivity to light, fainting or loss of consciousness, seizures, a sudden severe headache and nausea and vomiting. In such a situation the patient should be rushed to the hospital. In the US, there is a brain aneurysm rupturing every 18 minutes out of which 40% prove fatal. And of those that do survive, about 66% end up with some neurological deficit. Sadly, quite a good number of people die before they get to the hospital.

The treatment for brain aneurysms is through surgical repair, and though it’s risky, the risks often negate the dangers of living with an aneurysms – it’s like living with a live bomb in the brain, waiting for it to explode! The initial stages of treatment include the ‘wait and watch’ approach while the doctor monitors the size, type and location of the growth regularly. Medications are given to control the blood pressure and heart rate to reduce the chances of rupture.

Before heading for surgery of un-ruptured aneurysms, the doctor would first assess the patient’s age and health, family history of ruptured aneurysms and congenital conditions that increase the risk of a ruptured aneurysm. Along with a neurosurgeon and a neuroradiologist, surgery involving surgical clipping or endovascular coiling may be carried out to seal off an un-ruptured aneurysm. Surgical clipping involves opening up a part of the skull and placing a tiny metal clip at the neck of the aneurysm to stop blood flowing into it. The endovascular coiling procedure is less invasive and involves threading a catheter into the affected artery before pushing a soft platinum wire into the aneurysm and making the blood clot there, essentially sealing off the aneurysm from the artery.

Both procedures are risky and could lead to bleeding issues in the brain.

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