A brain aneurysm is a weakened area in the wall of a brain artery that bulges outward like a small balloon. While many aneurysms remain silent for years, others may rupture and cause a subarachnoid hemorrhage, a life-threatening emergency.
Modern cerebrovascular care focuses on early detection, precise imaging, and advanced microsurgical or endovascular treatments to prevent rupture and protect brain function.
Symptoms
Unruptured aneurysms often cause no symptoms and are found incidentally on MRI or CT angiography.
When symptoms appear, they are usually due to pressure on nearby structures or partial leakage of blood.
Possible warning signs include:
- Sudden, severe headache (“the worst headache of life”)
- Neck stiffness, nausea, or vomiting
- Vision changes or drooping eyelid (from nerve compression)
- Seizures or confusion
- Loss of consciousness in severe bleeding
Even small aneurysms can rupture unexpectedly — so early evaluation is critical.
Diagnosis
Diagnosis begins with CT angiography (CTA) or magnetic resonance angiography (MRA) to detect the aneurysm.
For precise characterization, digital subtraction angiography (DSA) remains the gold standard — providing detailed 3D images of the vessel, aneurysm neck, and surrounding branches.
Additional imaging like CT scan of the brain helps identify bleeding, vasospasm, or hydrocephalus if rupture has occurred.
Treatment Options
1. Microsurgical Clipping
A durable treatment where a tiny titanium clip is placed across the aneurysm neck through a microsurgical approach.
This permanently excludes the aneurysm from circulation while preserving normal vessels.
It’s often preferred for younger patients, broad-neck aneurysms, or complex vascular anatomy.
2. Endovascular Coiling / Flow-Diverter Stenting
Performed through a minimally invasive catheter via the groin or wrist, this approach fills the aneurysm with platinum coils or places a flow-diverting stent to redirect blood flow.
It’s especially suited for deep or multiple aneurysms, or for patients at higher surgical risk.
Most patients recover within 1–2 days.
3. Combined / Staged Approach
In selected cases, a combination of endovascular and microsurgical techniques provides optimal safety and long-term vessel stability.
Recovery & Follow-Up
After treatment, most patients spend a short period in a neuro-ICU for observation.
If the aneurysm ruptured, management focuses on preventing vasospasm, hydrocephalus, and rebleeding through medical therapy and close monitoring.
Follow-up imaging (MRA or DSA) is done at 6 months and 1 year to confirm aneurysm occlusion.
Rehabilitation may be needed in cases with neurological symptoms.
When to See a Neurosurgeon
Seek urgent medical help if you experience a sudden, severe headache, vision changes, or neck stiffness.
Even unruptured aneurysms require professional evaluation to assess rupture risk and decide on preventive treatment.