Brain Aneurysm (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Brain aneurysm facts
- What is a brain aneurysm and what causes a brain aneurysm?
- What are the signs and symptoms of brain aneurysm?
- How is brain aneurysm diagnosed?
- What is the treatment for brain aneurysm?
- What is the outcome of brain aneurysm?
- What are future directions for the treatment of brain aneurysm?
What is the treatment for brain aneurysm?
Treatment for a symptomatic aneurysm is to repair the blood vessels. Clipping and coiling are two treatment options.
- Clipping: A neurosurgeon can operate on the brain by cutting open the skull, identifying the damaged blood vessel and putting a clip across the aneurysm. This prevents blood from entering the aneurysm and causing further growth or blood leakage.
- Coiling: An interventional neurologist, neurosurgeon, or interventional radiologist can thread a tube through the arteries, as with an angiogram, identify the aneurysm, and fill it with coils of platinum wire or with latex. This prevents further blood from entering the aneurysm and resolves the problem.
Both these options have the risk of damaging the blood vessel and causing more bleeding, damaging nearby brain tissue, and causing the surrounding blood vessels to go into spasm; depriving brain tissue of blood supply and causing a stroke.
Prior, during, and after surgery, attention is paid to protect the brain and its blood vessels from potential further damage. Vitals signs are monitored frequently, and heart monitors are used to watch for abnormal heart rhythms. Medications may be used to control high blood pressure and prevent blood vessel spasm, seizure, agitation, and pain.
What is the outcome of brain aneurysm?
Brain aneurysms are deadly. About 10% of patients with a ruptured aneurysm die before receiving medical care. If untreated, another 50% will die within a month, with 25% of patients sustaining another bleeding episode within a week. Aside from the bleeding issues, there is significant risk of artery spasm leading to stroke.
Survival rates are increased in patients who present early to the hospital. Early diagnosis, aneursym repair, and control of blood vessel spasms with appropriate medications are all associated with increased survival.
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