How is a brain aneurysm diagnosed?
Because unruptured brain aneurysms often do not
cause any symptoms, many are discovered in people who are being treated for a
different condition.
If your doctor believes that you
have a brain aneurysm, you may have the following tests:
- Computed tomography (CT) scan. A CT scan
can help identify bleeding in the brain. Sometimes a
may be used if your doctor suspects that you have a ruptured cerebral aneurysm with a
subarachnoid hemorrhage.
- Computed tomography angiogram (CTA) scan. CTA is a more precise method of
evaluating blood vessels than a standard
. CTA uses a combination of CT scanning,
special computer techniques, and
(dye) injected into the blood to
produce images of blood vessels.
- Magnetic resonance angiography (MRA). Similar to a CTA,
uses a magnetic field and pulses of radio wave
energy to provide pictures of blood vessels inside the body. As with CTA and
cerebral angiography, a dye is often used during MRA to make blood vessels show
up more clearly.
- Cerebral angiogram. During
this X-ray test, a catheter is inserted through a blood vessel in the groin or
arm and moved up through the vessel into the brain. A dye is then injected into
the cerebral artery. As with the above tests, the dye allows any problems in
the artery, including aneurysms, to be seen on the X-ray. Although this test is
more invasive and carries more risk than the above tests, it is the best way to
locate small (less than 5 mm) brain aneurysms.
How is it treated?
Your doctor will consider several factors before
deciding the best treatment for you. Things that will determine the type of
treatment you receive include your age, size of the aneurysm, any additional
risk factors, and your overall health.
Because the risk of a
small (less than 10 mm) aneurysm rupturing is low and surgery for a brain
aneurysm is often risky, your doctor may want to continue to
observe your condition rather than perform surgery. If your aneurysm
is large or causing pain or other symptoms, though, or if you have had a previous
ruptured aneurysm, your doctor may recommend surgery.
The following surgeries are used to treat both ruptured and unruptured
brain aneurysms:
- Coil embolization.
During this procedure, a small tube is inserted into the affected artery and
positioned near the aneurysm. Tiny metal coils are then moved through the tube
into the aneurysm, relieving pressure on the aneurysm and making it less likely
to rupture. This procedure is less invasive and is believed to be safer than
surgical clipping, although it may not be as effective at reducing the risk of
a later rupture. It should be done in a large hospital where many such
procedures are done.
- Surgical clipping. This surgery involves placing a small metal clip around the
base of the aneurysm to isolate it from normal blood circulation. This
decreases the pressure on the aneurysm and prevents it from rupturing. Whether
this surgery can be done depends on the location of the aneurysm, its size, and
your general health.