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Brain aneurysm: Battling an often-silent killer

February 09, 2018

A brain aneurysm is a condition that occurs when a bulge or balloon forms in a blood vessel, primarily originating at the base of the brain. When one leaks or ruptures, it causes bleeding into the brain, known as a hemorrhagic stroke. A ruptured aneurysm quickly can become life-threatening and requires immediate treatment.

According to the Brain Aneurysm Foundation, six million, or 1 in 50, people in America have an aneurysm that has not yet ruptured. Every 18 minutes, an aneurysm ruptures, and about 40 percent of those are fatal.

“There are several theories about what cause brain aneurysms,” said Aqueel Pabaney, MD, neurosurgeon for Kettering Health Network. “They usually occur in older people with high blood pressure, but younger people can get them as well. Sometimes aneurysms even run in the family.”

In addition to family history, those over 40 years of age, women, and anyone with high blood pressure (or hypertension) are at an increased risk for a brain aneurysm. Illegal drug use (particularly cocaine), smoking, or traumatic head injury also can lead to a higher probability of the condition.

Symptoms and diagnosis

The Brain Aneurysm Foundation offers several warning signs of an aneurysm. These include localized headache, dilated pupils, blurred or double vision, pain above and behind the eye, weakness or numbness, and difficulty speaking.

“Unfortunately, most cases go unknown unless the aneurysm ruptures,” Dr. Pabaney explained. “But the most common symptoms include severe headaches, or the patient may become sleepy or comatose because the aneurysm has ruptured.” He added that some aneurysms are diagnosed incidentally while the patient is being examined for other conditions.

“Once a diagnosis has been made, an expert decision must be made whether to treat it or not and, if so, the best course of action,” Dr. Pabaney said. “We look at the risks of treatment versus observation, and we can tailor the treatment to the patient.”

Treatment of brain aneurysms

When identified early, treatment for brain aneurysms can be accomplished through one of two primary methods. The more traditional method is open surgery. “A part of the skull is removed, and you put a clip across the blood vessel so the blood cannot enter it and cause the aneurysm to rupture,” Dr. Pabaney said. “But over the last several years, a new minimally invasive, endovascular treatment has surfaced.”

The endovascular procedure does not require brain surgery. Instead, a catheter is inserted into a blood vessel, in this case entering through a small puncture in the groin or the arm. A wire is then floated through the blood vessel into the aneurysm, and platinum coils are deposited to avoid blood flow and prevent the rupture.

While there are pros and cons to either treatment, having options allow treatments to be tailored for the individual patient, rather than using the “one size fits all” method.

A diverse team can provide the best care

Choosing the best possible care can be difficult, especially with the complex dangers of treating brain aneurysms. The team at Kettering Health Network is fellowship-trained, which means having additional years of specialized study to increase their expertise and skill set in treating brain aneurysms.

“We meet on a regular basis to discuss complex cases,” Dr. Pabaney says. “We have multi-specialty input from different physicians. That helps us make a more appropriate and comprehensive plan for each patient. In addition, since we are a smaller group, we are able to deliver more personalized care and spend more time with our patients.”

If you have concerns about your own risk for a brain aneurysm, or if you already have been diagnosed and want to learn more about your treatment options, click here to visit our website. You also can schedule an appointment with one of our neurosurgeons by calling 1-844-211-5482.