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Dr. Sharad Rajamani

Consultant - Neurosurgery

Manipal Hospitals, Whitefield

Cerebral Aneurysms – What Is It And How To Manage It?

Posted On: May 08, 2023

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Cerebral Aneurysms treatment in Whitefield

We often hear about heart attacks or strokes occurring in people, but little is known about Cerebral Aneurysms.  Aneurysms of the brain are like time bombs whose fuse settings are unknown.  This is a potentially fatal condition if left unnoticed and untreated. Today, let’s understand what this relatively unknown deadly condition is.  How we can identify, preventive measures and treat cerebral aneurysms. 

What is Cerebral Aneurysm and How Serious is it?

Cerebral Aneurysm (also called Brain Aneurysm or Berry Aneurysm) is a balloon-like bulge that forms in the wall of an artery in the brain. It develops when a part of the artery wall becomes weak and thin, causing it to abnormally expand or create a sac (balloon). They keep expanding and can burst, leaking blood into and around the brain – intraparenchymal haemorrhage or subarachnoid haemorrhage. Rarely do they enlarge to the point where they pressure the brain or form clots which break off and obstruct blood flow in the normal vessels.

Over the years, brain aneurysms are becoming more common and afflict more people. In India, roughly 1% of people report having cerebral aneurysms, and more than half of them come to hospitals after they have ruptured. About 85% of ruptured aneurysms can result in severe neurological deficits, paralysis or coma, or death. The remaining have some form of changes in personality and performance.  With the increase in life expectancy comes increasing metabolic diseases like diabetes, hypertension and other chronic illnesses, predisposing us to another silent explosive devastating disease – a ruptured cerebral aneurysm. 

People in the productive age group (between the ages of 35 and 65) seem to be commonly diagnosed with this condition. This life-altering event is more common in men compared to women.

“Over 92% of aneurysm patients become totally dependent on others for everyday tasks.”

BUT….. 

The good news is - “The success rate of brain aneurysm treatment in time is around 92 to 97%.”

Visit a top hospital for cerebral aneurysm treatment in Whitefield if you are diagnosed with this condition and reduce the risks of further complications.

Symptoms of Cerebral Aneurysms

A ruptured aneurysm can have devastating effects on the body and quality of life and may lead to death. The common symptoms of a ruptured aneurysm can be:

Sudden and intense headaches (thunderclap headaches)

  • Vomiting

  • Unconsciousness 

  • Difficulty in breathing

  • Severe neck pain

  • Inability to move 

Before rupture, many aneurysms show some or all these warning signs for a few days or months(called a sentinel bleed). Thus, it is crucial that we look for symptoms and seek medical attention immediately to avoid any complications. 

An aneurysm with no rupture may not always show evident signs. Only if the aneurysm is large, it may cause symptoms such as:

  • Face numbness (on one side mostly).

  • Pain near the eye area.

  • Dilation of pupils

  • Change in vision

  • Double vision

Please book an appointment with a Consultant – Neurosurgery at Manipal Hospital Whitefield to receive appropriate treatment for your symptoms.

Causes of Cerebral Aneurysms

Certain environmental factors and metabolic diseases tend to be the cause of developing an aneurysm. Rarely, there can be genetic and birth conditions associated with berry aneurysms such as inherited connective tissue disorders, polycystic kidney disease, narrow aorta (blood vessel), and brain arteriovenous malformation.

Who Are at High Risk of Cerebral Aneurysms?

People who are at high risk of Cerebral Aneurysms include:

  • High cholesterol

  • High blood pressure or hypertension.

  • Use of narcotics (particularly those that raise blood pressure like cocaine).

  • Smoking cigarettes.

  • Excessive alcohol consumption (both Bingeing and Chronic Excessive).

  • Use of oral contraception.

  • Family history of aneurysms.

  • Chronic Kidney disease.

Managing Patients with Cerebral Aneurysms

  • Early detection remains the key to preventing the complications of cerebral aneurysms. A special CT scan of the brain is called a CT Angiogram to detect aneurysms.  This study takes 15 minutes to set up and around 13-17 seconds to perform the test itself and is done in a CT scan machine. An injection (called contrast) is given and the CT scan is performed as the contrast flows through the arteries of the brain. Earlier one would need an angiogram to diagnose the aneurysm, which is the insertion of a catheter into the blood vessel in the arm or groin and sending it to the brain and then performing the test.  This was invasive, but today with improved technology, the CT Angiogram is very simple with excellent results and is being considered an extremely sensitive tool for diagnosis. 

  • People who have other comorbidities, such as chronic kidney disease, hypertension, sudden late onset headaches or change in migraine pattern or type and diabetes, should undergo this test once every 2-3 years because they are at high risk of developing an aneurysm.

Treatment for Cerebral Aneurysms

A cerebral aneurysm is treated depending on its size, shape, and location by either Coil Embolization or Clipping. 

  • Clipping

Clipping is a procedure for which a craniotomy (an open surgery) must be performed to place the clip on the aneurysm or reconstruct the aneurysm and the parent artery. The clipping is more sustainable, and has a better closure rate than the former, but has pain and swelling as the side effects of the surgery. 

  • Coil Embolization

Coil Embolization is a newer and minimally invasive procedure in which a stent is used through a catheter in the groin or forearm (similar to heart stents) to coil or bypass the blood flow in the aneurysm. It requires less recovery time than open surgery to repair a cerebral aneurysm.

It is important to note that the risks and complications of either are the same for both procedures.  They complement each other rather than are exclusive. Also, it is crucial to be aware of the warning signs and get evaluated regularly to prevent the serious consequences of a ruptured aneurysm.

Consult a top neurosurgeon in Whitefield for the diagnosis and treatment of cerebral aneurysms.

How to Reduce the Risks of Aneurysms? 

We can reduce the risk of cerebral aneurysms by leading a healthier lifestyle, especially by monitoring and controlling our blood pressure and cholesterol and exercising daily, while avoiding smoking and binge drinking.

“A Stitch in Time Saves Nine”

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