All About Brain Aneurysms: Causes, Symptoms, and Lifesaving Treatment Options at Inova

Sidhartha Chandela, MD, is a board certified and fellowship-trained minimally invasive neurosurgeon with Inova Neurosurgery. Dr. Chandela specializes in both brain and spinal neurosurgery.

Your body’s arteries are strong, muscular blood vessels that carry oxygen-rich blood from your heart to every cell in your body, including your brain. But with each heartbeat, your arteries are under pressure. Sometimes, all that pressure causes a weak spot to develop in an artery wall. Like a bubble, it’s an abnormally thin spot that bulges out from the vessel. This weak spot – called an aneurysm – can develop anywhere, including the brain.

Why aneurysms develop and who is at risk?

About 1 percent of the population has a brain aneurysm. A brain aneurysm can develop for hereditary or genetic reasons – some people are born with a weak spot in one of the brain’s blood vessels, while others are more likely to develop one over time because of a predisposition in their DNA. A brain aneurysm can develop at any time in your adult life – and unlike many other blood vessel disorders (from high blood pressure to narrowing of the arteries), lifestyle factors like diet and exercise don’t seem to play a role in whether an individual develops a brain aneurysm. That means there is no real way to prevent a brain aneurysm from forming.

Most of the time people don’t know that they have a brain aneurysm, because aneurysms don’t cause symptoms. Some people learn that they have a brain aneurysm by chance, when they have a brain scan for some other reason. And for a few unlucky people, the first sign they have a brain aneurysm is when it bleeds.

When aneurysms bleed

The Brain Aneurysm Foundation estimates that about 30,000 people experience a ruptured brain aneurysm each year in the United States. A rupture happens when the thin, bulging part of the aneurysm tears, causing bleeding. A ruptured brain aneurysm is a life-threatening emergency, and 50 percent of people who experience one do not survive it. Symptoms include extreme headache (“the worst headache of your life”), nausea, vomiting, seizures, paralysis, and coma. If this happens to you or someone around you, call 911 right away.

What are the treatment options for ruptured brain aneurysms?

The goal of treatment is to stop the bleeding, while keeping the blood vessel itself open so blood can flow through it and nourish brain cells.

There are two main techniques that we can use to treat a ruptured brain aneurysm: coiling and clipping. Coiling is a minimally invasive procedure with no cutting. The physician threads a tiny tube called a catheter from an access point in the leg through the blood vessels and up into the site of the aneurysm. Then, the doctor fills the bulging spot with tiny coils, the thickness of a human hair, blocking the aneurysm from continuing to bleed.

Clipping is an open surgical procedure in which a neurosurgeon opens the skull and places a titanium clip across the aneurysm, sealing it off like a clip across the top of a potato chip bag. Both options are very effective in destroying the aneurysm, although it’s important to note that many people have lingering neurological damage as a result of the bleeding from the rupture.

What if the brain aneurysm hasn’t ruptured?

Among people who have an unruptured aneurysm, risk factors for rupture include smoking, high blood pressure, a family history of brain aneurysms, and other systemic blood vessel disorders. People who find out they have an unruptured aneurysm should consult with a neurosurgeon who specializes in aneurysms to put a monitoring plan in place and conduct screening for family members, if indicated. In some cases, treatment may be recommended.  

At Inova, our surgeons have more than 50 years of experience brain aneurysm repair at one of Northern Virginia’s largest and highest volume brain aneurysm centers. We have the resources and technology to treat aneurysms using minimally invasive coiling and open surgical techniques. Our multidisciplinary approach means that we study every case as a group, discussing all of the available options. Patients benefit from multiple perspectives, creating the best combination in terms of quality, safety, and patient outcomes. To learn more about our neurosurgery practice and our brain aneurism specialists, or to speak with an Inova neurosurgeon about your care, contact Inova Neurosurgery or call (571) 472-4100.

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