Aneurysms in the brain occur when there is a weakened area in the wall of a blood vessel. The danger of an aneurysm is that it will rupture, something that a patient may describe as "the worst headache of my life."
At Edward-Elmhurst Healthcare, if you are suspected of having an aneurysm in the brain, you will be evaluated by a multidisciplinary team, including a vascular neurologist, neurointerventional surgeon and neurosurgeon, to determine the best course of treatment.
Not all aneurysms need to be treated right away. In some cases, such as when the aneurysm is very small and less likely to break open, it may be best to monitor the aneurysm with advanced imaging to ensure it’s not getting bigger.
When immediate treatment of an unruptured aneurysm is necessary, we can provide aneurysm coiling, a minimally invasive technique performed in our state-of-the-art neurointerventional lab.
What is a cerebral (brain) aneurysm?
There are many different types of aneurysms. A berry aneurysm—which looks like a berry—can vary in size from a few millimeters to over a centimeter. Giant berry aneurysms can reach well over two centimeters. Other types of cerebral aneurysm involve widening of an entire blood vessel, or they may appear as a "ballooning out" of part of a blood vessel.
About five percent of the population has some type of aneurysm in the brain, but only a small number of these aneurysms cause symptoms or rupture. A ruptured aneurysm is a medical emergency that requires immediate medical treatment.
An aneurysm may be present from birth (congenital) or it may develop later in life, such as after a blood vessel is injured. Atherosclerosis and infection can also cause aneurysms. The combination of blood in the brain tissues (a subarachnoid hemorrhage) and elevated pressure inside the skull can cause symptoms such as: nausea, vomiting, seizures, confusion and changes in neurologic function that can be as serious as coma.
Risk factors for an aneurysm
Risk factors for an aneurysm include a family history of cerebral aneurysms and certain medical problems, such as polycystic kidney disease, coarctation of the aorta, and high blood pressure. For patients who experience symptoms, or have medium or large aneurysms that are expanding, surgical or endovascular treatment is recommended.
Treatment for an aneurysm
Edward-Elmhurst offers a variety of treatment options for an aneurysm.
Some patients may be too ill to have surgery or it may be too dangerous to treat the aneurysm because of its location. In those cases, treatment may include bed rest and restrictions on activity. Your doctor may also prescribe drugs to prevent seizures and medicines to control headaches and blood pressure.
Aneurysm coiling is a minimally invasive technique to treat unruptured aneurysms in the brain. Our physicians perform aneurysm coiling in a special Neurointerventional Lab located at Edward Hospital in Naperville. Patients are under general anesthesia or moderate sedation. To treat a cerebral aneurysm using coiling, your neurointerventional surgeon inserts a catheter into the artery in the groin and threads it up to the brain. Using injected dye, your surgeon is able to see the artery and the aneurysm.
Then, your neurointerventional surgeon carefully inserts tiny platinum coils into the aneurysm, packing the aneurysm so that blood can no longer fill the space. The platinum coils seal off the aneurysm, preventing it from rupturing. Remaining blood in the aneurysm forms a clot around the coils. That combination prevents further blood flow into the aneurysm.
After the procedure and provided there are no complications, you’ll typically spend two days in our Neuro Intensive Care Unit, where our physicians and neuro ICU nurses will care for you.
Aneurysm clipping is an open brain surgery performed by one of our cerebrovascular neurosurgeons. Under general anesthesia, your surgeon removes a small portion of the skull to gain access to the brain (craniotomy), and then uses microscopes and small instruments to isolate the aneurysm and secure a clip at its neck.
The delicate nature of the surgery requires the expertise of a cerebrovascular surgeon to protect healthy brain tissue and prevent compromising blood flow to other areas of the brain.
Following the procedure, you’ll spend an average of 10 days in our Neuro Intensive Care and Neuro "Stepdown" Units, where highly trained neuro ICU nurses will carefully monitor you for changes in neurological function.
Our physicians and neuro ICU nurses will look closely for vasospasm (constriction) of the brain vessels, which is a frequent complication following aneurysm surgery or aneurysm rupture. We can use medications to treat vasospasm.
In addition, beginning the first day after your surgery, our neuroscience-trained physical therapists and occupational therapists will work with you to help restore your functioning.
Your Edward-Elmhurst healthcare team will evaluate the location and shape of the aneurysm to determine if this is the right treatment option for you.
Recovery from an aneurysm
Recovery from a ruptured aneurysm is a lengthy process requiring complex care in our Neuro Intensive Care Unit. Critically ill neurological patients receive the latest in medical management, including frequent neurological assessments that can detect subtle changes in neurological function and any potential for complications.
Edward-Elmhurst provides integrated care from a team of neurologists, neurointerventional surgeons, neurosurgeons, skilled critical care nurses, and rehabilitation therapists to help you regain strength, maximize functioning, and get you on the road to recovery.