Brain Aneurysm Treatment

Diagnosis

The doctor will evaluate whether there has been bleeding into the area between the brain and surrounding tissues if the patient suddenly develops a severe headache or other symptoms that could be caused by a ruptured aneurysm.

In addition, if the patient is experiencing signs of an unruptured brain aneurysm, such as double vision, pain behind the eye, or vision alterations, they can be subjected to additional testing.

Diagnostic tests consist of the following:

• Imaging tests:
  • Computerized tomography (CT): utilize a specific X-ray; this test is used to evaluate whether the patient has a brain hemorrhage or another kind of stroke. As part of the test, a dye maybe be injected that facilitates the visualization of blood flow in the brain and reveal the presence of an aneurysm.
  • Magnetic resonance imaging (MRI): To produce precise images of the brain in either 2D or 3D, this imaging method combines radio waves and a magnetic field. The existence of an aneurysm may be discovered via MR angiography, a type of MRI that carefully examines the arteries.
• Cerebrospinal fluid test: The process of using a needle to extract cerebrospinal fluid from your spine is known as a lumbar puncture. Red blood cells will most likely be present in the fluid surrounding the brain and spine (cerebrospinal fluid) if the patient experienced a subarachnoid hemorrhage. A test of their cerebrospinal fluid can help make a diagnosis if they have symptoms of a ruptured aneurysm.
• Cerebral angiogram (Cerebral arteriogram): This treatment involves inserting a thin, flexible tube (catheter) into a major artery, typically in the wrist or groin. To reach the arteries of the brain, the catheter passes through the heart. The brain’s arteries are shown by a particular dye that is injected into the catheter. The condition of the arteries can then be seen in detail and an aneurysm can be found using a series of X-ray scans. When other diagnostic tests are insufficient, a cerebral angiography is commonly done.
• Screening for brain aneurysm: It is not advised to use imaging examinations to check for unruptured brain aneurysms unless the patient is at a high risk. Discuss the advantages of a screening test with health care practitioner.

Treatment

Surgery

• Brain aneurysm surgery: A ruptured brain aneurysm can usually be treated by the following:
  • Surgical clipping is a procedure to close off an aneurysm: To access the aneurysm and find the blood supply that feeds the aneurysm, the neurosurgeon must remove a portion of the skull then a tiny metal clip is then inserted on the aneurysm’s neck by the neurosurgeon to halt blood flow to it.
  • Endovascular treatment: compared to surgical clipping, is a less invasive process. To reach the aneurysm, the surgeon threads a catheter into your body from an artery, typically in your wrist or groin. The aneurysm is then removed from inside the blood vessel using a flow diverter, an intraluminal flow disrupter, a stent, or coils, or various combinations of these devices.
• Flow diverters: Tubular stent-like implants (flow diverters), which act by diverting blood flow away from an aneurysm sac, are among the more recent therapies for brain aneurysms. The diversion blocks blood flow inside the aneurysm and encourages the parent artery to be rebuilt. Larger aneurysms that cannot be safely treated by other methods may benefit especially from flow diverters.

Other treatments for ruptured aneurysms

It is the goal of additional treatments to treat ruptured brain aneurysms and manage symptoms or complications.

• Medications:
  • Pain relievers: acetaminophen for pain, is a potential treatment for headache pain.
  • Calcium channel blockers: might reduce the possibility of experiencing severe symptoms from vasospasm, which is a potentially dangerous
    complication of a ruptured aneurysm. Nimodipine lowers the risk of delayed brain injury brought on by insufficient blood flow after subarachnoid hemorrhage.
• Anti-seizure medications: could be applied to treat aneurysm-related seizures. These drugs include valproic acid, levetiracetam, phenytoin, and others.
• Interventions to avoid stroke from insufficient blood flow: IV injections are used as interventions to dilate the blood vessels that raises the blood pressure to counter those resistances of narrowed blood vessels.
  Angioplasty is a substitute treatment for stroke prevention. In this treatment, a surgeon inserts a catheter to widen a cerebral blood artery that has become restricted due to vasospasm. To dilate blood arteries in the affected area, a medication known as a vasodilator may also be administered.
• Ventricular or lumbar draining catheters and shunt surgery: It is possible to insert a catheter to drain extra fluid into an external bag from the areas inside the brain that are filled with fluid or from the region around the brain and spinal cord. It can reduce pressure on the brain brought on by hydrocephalus brought on by a ruptured aneurysm.
• Rehabilitative therapy: Physical, linguistic, and occupational therapy may be required to relearn skills after brain damage following a subarachnoid hemorrhage.

Treatment for unruptured brain aneurysms

• Endovascular coiling: An unruptured brain aneurysm can be closed off using a surgical clip, an endovascular coil, or a flow diverter to help stop it from rupturing in the future. The potential risks may outweigh the any possible benefit.

When providing therapy suggestions, one should take into consideration the following:

• The size, location, degree of irregularity, and general appearance of the aneurysm.
• Patient’s age and general health.
• Family history of ruptured aneurysm
• Congenital issues that increase the risk of an aneurysm rupturing

Consult with the doctor about taking medication to control the high blood pressure. Controlling the blood pressure well may reduce the chance of rupture if the patient has a brain aneurysm.